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INFLUENZA IMMUNIZATION CONSENT LE COM CENTER FOR HEALTH AND AGING 3910 Scraper Ave Erie PA 16508 (814) 4535072SCREENING QUESTIONNAIRE FOR INJECTABLE INFLUENZA VACCINE 1. Has the Vaccine Information
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How to fill out influenza immunization consent lecom

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How to fill out influenza immunization consent lecom

01
To fill out an influenza immunization consent form at LECOM, follow these steps:
02
Obtain the consent form from LECOM or download it from their website.
03
Read through the form carefully, making sure you understand all the information and requirements.
04
Provide your personal details such as your name, date of birth, and contact information.
05
Review the sections related to the influenza immunization, including the benefits, risks, and alternatives.
06
Check the box indicating your consent to receive the influenza immunization.
07
If necessary, provide any additional information or medical history that LECOM requires.
08
Sign and date the consent form.
09
Return the completed form to LECOM as instructed, either by mail or in person.
10
Keep a copy of the form for your records.

Who needs influenza immunization consent lecom?

01
Anyone who wants to receive the influenza immunization at LECOM needs to fill out the influenza immunization consent form.
02
This may include LECOM students, staff, faculty, or members of the community who visit the LECOM healthcare facilities.
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Influenza immunization consent lecom is a document that provides consent for individuals to receive the influenza vaccine, ensuring that they are informed about the vaccine's benefits and risks.
Individuals receiving the influenza vaccine, or their guardians if they're minors, are required to file the influenza immunization consent lecom.
To fill out the influenza immunization consent lecom, individuals must provide personal information, confirm understanding of the vaccine, and sign the document to indicate consent.
The purpose of the influenza immunization consent lecom is to document informed consent for receiving the influenza vaccine and to ensure that recipients understand the importance and potential side effects of the vaccine.
The influenza immunization consent lecom must report personal details of the recipient, information about the vaccine, acknowledgment of risks and benefits, and the signature of the individual or guardian.
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