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Consent FormInfluenza Quadrivalent Vaccine Consent Form Section 1: Information for Individuals receiving the 201920 Quadrivalent Influenza Vaccine (please print) NAME (Last) (First) (M.I.) DATE OF
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Any individual who wishes to receive the influenza vaccine from a healthcare provider.
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The exceltmpcominfluenza-vaccine-consent-form is a document that provides consent for individuals to receive the influenza vaccine, ensuring that they understand the benefits and risks associated with the vaccination.
Individuals who wish to receive the influenza vaccine, as well as guardians of minors, are required to file this consent form.
To fill out the form, individuals need to provide personal information such as name, date of birth, and contact details, along with a signature to indicate consent for the vaccine.
The purpose of the form is to obtain informed consent from individuals before administering the influenza vaccine, ensuring they are aware of the vaccine's purpose, potential side effects, and any other relevant information.
The form must include personal details of the individual receiving the vaccine, a confirmation of understanding the vaccine information, and a signature to indicate consent.
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