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Site/Clinic Location: University of CalgaryInfluenza Immunization Record Please fill in the following fields to the best of your ability. A provincial healthcare number is not required this year but
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How to fill out influenza immunization record

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How to fill out influenza immunization record

01
Step 1: Obtain the influenza immunization record form from a healthcare provider or clinic.
02
Step 2: Fill out personal information such as full name, date of birth, and contact information.
03
Step 3: Provide details about the influenza vaccine received, including the date of administration, vaccine brand, lot number, and healthcare provider's signature.
04
Step 4: Keep a copy of the completed influenza immunization record for your records.

Who needs influenza immunization record?

01
Individuals who have received the influenza vaccine and need documentation for school, work, travel, or medical purposes.
02
Healthcare professionals who need to keep track of patients' influenza immunization history.
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Influenza immunization record is a document that provides information about an individual's flu vaccination history.
Individuals who work in certain industries or occupations may be required to file their influenza immunization record, as mandated by their employers or regulatory bodies.
To fill out an influenza immunization record, you must provide details about your vaccination history, including the dates of vaccinations, type of vaccine administered, and any relevant healthcare provider information.
The purpose of influenza immunization record is to keep track of an individual's flu vaccination status, which can help prevent the spread of influenza and ensure public health protection.
Information such as the individual's name, date of birth, vaccination dates, type of vaccine administered, and healthcare provider information must be reported on influenza immunization record.
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