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Tennessee Department of Health School Located Influenza Vaccination Project
Student Consent Form and Influenza Immunization Documentation Form
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How to fill out student influenza vaccination consent

How to fill out student influenza vaccination consent
01
Obtain the student influenza vaccination consent form from your school or healthcare provider.
02
Read the instructions and guidelines provided with the form.
03
Fill in your personal information, including your full name, date of birth, and contact information.
04
Provide details about your current school, grade, and classroom.
05
Check the box indicating your consent for receiving the influenza vaccination.
06
If applicable, provide any additional information or medical history that is requested on the form.
07
Review the completed form for accuracy and completeness.
08
Sign and date the form at the designated area.
09
Return the completed consent form to your school or healthcare provider as instructed.
10
Keep a copy of the filled-out consent form for your records.
Who needs student influenza vaccination consent?
01
Students who are required or recommended to receive the influenza vaccination by their school or local health authorities need student influenza vaccination consent.
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What is student influenza vaccination consent?
Student influenza vaccination consent is a form that allows parents or guardians to give permission for their child to receive the influenza vaccine.
Who is required to file student influenza vaccination consent?
Parents or guardians of students are required to file student influenza vaccination consent.
How to fill out student influenza vaccination consent?
To fill out student influenza vaccination consent, parents or guardians must provide their contact information, the student's information, medical history, and sign the consent form.
What is the purpose of student influenza vaccination consent?
The purpose of student influenza vaccination consent is to ensure that parents or guardians authorize the administration of the influenza vaccine to their child.
What information must be reported on student influenza vaccination consent?
Student influenza vaccination consent must include the student's name, date of birth, medical history, parent or guardian contact information, and signature of parent or guardian.
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