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EAST SHORE DISTRICT HEALTH DEPARTMENT 20212022 Influenza Clinic 688 East Main St Branford, CT (203)4814233Private Pay rate: Quadrivalent Vaccine $35.00High Dose Vaccine $55.00Flublok $55.00Clinic
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How to fill out flu consent form 2021-2022
How to fill out flu consent form 2021-2022
01
Obtain a flu consent form for the 2021-2022 season from a healthcare provider, school, or organization.
02
Read the instructions on the form carefully and gather all the necessary information.
03
Provide information about the person receiving the flu vaccine, including their name, date of birth, and any known allergies.
04
Indicate whether consent is given for the flu vaccination and any other relevant options.
05
Sign and date the consent form as the parent or legal guardian if filling it out for a minor.
06
Ensure all the required fields are completed correctly and legibly.
07
Submit the filled-out form to the appropriate recipient, such as the healthcare provider or school.
Who needs flu consent form 2021-2022?
01
Anyone who wishes to receive the flu vaccine for the 2021-2022 season may need to fill out a flu consent form. This typically includes individuals who are under the age of 18, as they require parental or guardian consent. However, requirements may vary depending on the specific healthcare provider, school, or organization administering the vaccinations. It is recommended to consult with the relevant authorities to determine who specifically needs to fill out the flu consent form.
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What is flu consent form?
Flu consent form is a document that allows an individual to give their permission for receiving a flu vaccine or treatment.
Who is required to file flu consent form?
Any individual who wishes to receive a flu vaccine or treatment is required to fill out and file a flu consent form.
How to fill out flu consent form?
To fill out a flu consent form, an individual needs to provide their personal information, medical history, consent for treatment, and signature.
What is the purpose of flu consent form?
The purpose of flu consent form is to ensure that individuals have given their informed consent for receiving a flu vaccine or treatment.
What information must be reported on flu consent form?
The flu consent form must include the individual's personal information, medical history, consent for treatment, and signature.
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