Get the free 2016-2017 School Based Influenza Vaccine Consent Form - calhounschools

20162017 School Based Influenza Vaccine Consent Form Gordon County Health Department Section 1: Information about Student to Receive Influenza Vaccine (please print) STUDENTS NAME (Last) (First) STUDENTS

How to fill out 2016-2017 school based influenza

How to fill out 2016-2017 school based influenza

1. Begin by obtaining a copy of the 2016-2017 school based influenza form.
2. Read through the form carefully to understand the information it requires.
3. Fill in your personal details, such as your name, date of birth, and contact information.
4. Provide information about your school, including its name, address, and contact details.
5. Answer any health-related questions on the form, such as whether you have any allergies or pre-existing medical conditions.
6. Indicate whether you have received the influenza vaccine for the 2016-2017 school year.
7. If you have not received the vaccine, consider discussing it with your healthcare provider or school nurse.
8. Complete any additional sections or sign the form as required.
9. Double-check all the information you have provided for accuracy and legibility.
10. Submit the filled-out form to the designated person or department at your school.

Who needs 2016-2017 school based influenza?

1. The 2016-2017 school based influenza form is typically required for students, teachers, and staff members of schools.
2. Any individual who attends or works at a school during the specified school year may need to fill out this form.
3. It helps monitor and prevent the spread of influenza within the school community by ensuring individuals are vaccinated or providing necessary health information.
4. Specific requirements may vary depending on local regulations and policies.

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What is school based influenza vaccine?

School based influenza vaccine is a program where influenza vaccines are administered to students in a school setting.

Who is required to file school based influenza vaccine?

School administrators or healthcare providers responsible for administering the vaccines are required to file school based influenza vaccine.

How to fill out school based influenza vaccine?

To fill out school based influenza vaccine, the administrator or healthcare provider must record the student's information, vaccine administered, and any adverse reactions.

What is the purpose of school based influenza vaccine?

The purpose of school based influenza vaccine is to protect students from the flu and reduce the spread of influenza in schools.

What information must be reported on school based influenza vaccine?

The information reported on school based influenza vaccine includes student name, date of birth, vaccine administered, date of administration, and any adverse reactions.