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FLU MIST CONSENT FORM LAST NAME FIRST NAME ADDRESS CITY/STATE EMAIL PHONE DATE OF BIRTH AGE ZIP SEX: Male Female Please check off method of payment (cash, check, credit card or PRIMARY insurance)

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What is flu mist consent form-1?

Flu mist consent form-1 is a document that allows individuals to provide consent for receiving the flu mist vaccine.

Who is required to file flu mist consent form-1?

Parents or legal guardians of minors are required to file flu mist consent form-1 on behalf of the child.

How to fill out flu mist consent form-1?

Flu mist consent form-1 can be filled out by providing personal information, medical history, and signing the consent section.

What is the purpose of flu mist consent form-1?

The purpose of flu mist consent form-1 is to ensure that individuals understand the risks and benefits of receiving the flu mist vaccine and provide informed consent.

What information must be reported on flu mist consent form-1?

Information such as name, date of birth, medical history, allergies, and signature must be reported on flu mist consent form-1.

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