Get the free 2014-15 School Based Influenza Vaccine Consent Form TOOMBS COUNTY HEALTH DEPARTMENT ...
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2014-15 School Based Influenza Vaccine Consent Form TOMBS COUNTY HEALTH DEPARTMENT Section 1: Information About Student to Receive Influenza Vaccine (please print) STUDENT S NAME (Last) (First) (Middle
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How to fill out 2014-15 school based influenza
How to fill out 2014-15 school based influenza:
01
Make sure you have the necessary forms: Obtain the 2014-15 school based influenza form from your school or healthcare provider.
02
Provide personal information: Fill in your name, date of birth, and any other required personal details on the form.
03
Answer screening questions: Respond to questions about your health, symptoms, and recent exposure to illnesses. Be honest and accurate in your answers.
04
Indicate vaccination status: Specify whether you have received the influenza vaccine and if so, provide the date of vaccination.
05
Provide contact information: Include your phone number and address so that the school or healthcare provider can reach you if needed.
06
Follow any additional instructions: Pay attention to any specific instructions provided on the form, such as whether to include additional documentation or signatures.
07
Submit the form: Once you have completed all the required fields, submit the form as instructed (e.g., return it to the school office or healthcare provider).
Who needs 2014-15 school based influenza:
01
Students: All students attending school during the 2014-15 academic year typically need to complete the school based influenza form. This helps monitor and prevent the spread of influenza in educational settings.
02
Parents or guardians: It is the responsibility of parents or guardians to fill out the form on behalf of their minor children who are attending school.
03
School administrators and healthcare providers: These professionals need the completed forms to track and manage influenza cases in schools, implement preventive measures, and identify potential outbreaks.
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