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CLIFTON HEALTH DEPARTMENT 900 Clifton Ave., Clifton, NJ 07013 (973) 4705760 CHILD INFLUENZA CONSENT FORM (6 months through 18) NAME (please print) MALE ()ADDRESS: CITY: PHONE #: BIRTHDATE: / / FEMALE

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What is child consent flu form?

Child consent flu form is a document that must be filled out by a parent or legal guardian to give permission for their child to receive the flu vaccine.

Who is required to file child consent flu form?

Parents or legal guardians are required to file the child consent flu form.

How to fill out child consent flu form?

To fill out the child consent flu form, parents or legal guardians must provide their child's personal information, medical history, and sign the form to give consent for the flu vaccine.

What is the purpose of child consent flu form?

The purpose of the child consent flu form is to ensure that parents or legal guardians are aware of and give consent for their child to receive the flu vaccine.

What information must be reported on child consent flu form?

The child consent flu form must include the child's name, date of birth, medical history, any allergies, and the parent or legal guardian's contact information.

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