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PRE Immunization QUESTIONNAIRE FOR THE FLU SHOT 20162017 SEASON Family name:First name:Phone number:Date of birth:Age: (BY/MM/DD)Email: (I consent to receive information and promotional offers from

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How to fill out pre immunisation questionnaire

01

Step 1: Obtain a copy of the pre immunisation questionnaire.

02

Step 2: Review the questionnaire and gather all the necessary information.

03

Step 3: Start filling out the questionnaire by providing your personal details such as name, date of birth, and contact information.

04

Step 4: Answer all the questions honestly and accurately.

05

Step 5: Pay special attention to any specific instructions or additional documentation required.

06

Step 6: Once you have completed the questionnaire, double-check all the information for any errors or omissions.

07

Step 7: Submit the filled-out pre immunisation questionnaire to the relevant healthcare provider or facility.

08

Step 8: Wait for further instructions or confirmation from the healthcare provider regarding your immunisation status.

Who needs pre immunisation questionnaire?

01

Anyone who is scheduled to receive immunisation shots or vaccines should fill out a pre immunisation questionnaire.

02

This typically includes individuals of all ages, from infants to adults, who are due for vaccination.

03

The questionnaire helps healthcare providers assess the individual's medical history, allergies, previous immunisations, and any potential contraindications before administering the vaccines.

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What is pre immunisation questionnaire?

The pre immunisation questionnaire is a form that collects important information about a person's health history and any potential risks or contraindications to receiving a vaccine.

Who is required to file pre immunisation questionnaire?

Anyone who is planning to receive a vaccine is required to fill out a pre immunisation questionnaire.

How to fill out pre immunisation questionnaire?

The pre immunisation questionnaire can usually be filled out online or in person at a healthcare provider's office. It typically involves answering questions about past illnesses, allergies, and medications.

What is the purpose of pre immunisation questionnaire?

The purpose of the pre immunisation questionnaire is to ensure that the person receiving the vaccine is in good health and does not have any risk factors that would make the vaccine unsafe for them.

What information must be reported on pre immunisation questionnaire?

The pre immunisation questionnaire typically asks for information about past illnesses, allergies, medications, and any previous reactions to vaccines.

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