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I'm or intranasal form20142015 Influenza Vaccine School Clinic Consent Form Section 1: Information about Child to Receive Vaccine (please print) STUDENTS NAME (Last)(First)(M.I.)PARENT/LEGAL GUARDIANS

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What is influenza vaccine school clinic?

Influenza vaccine school clinic is a program where influenza vaccines are administered to students at school.

Who is required to file influenza vaccine school clinic?

Schools and school districts are required to file influenza vaccine school clinic.

How to fill out influenza vaccine school clinic?

Influenza vaccine school clinic can be filled out online or through a paper form provided by the school or district.

What is the purpose of influenza vaccine school clinic?

The purpose of influenza vaccine school clinic is to prevent the spread of influenza among students and staff at school.

What information must be reported on influenza vaccine school clinic?

Information such as the number of vaccines administered, the dates of administration, and any adverse reactions must be reported on influenza vaccine school clinic.

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