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COVID-19 + FLU VACCINE CONSENT FORM Please complete form with information about the person who is receiving the vaccine (please print)Clinic Use: M12+ M611 M6 JJNvxPf12+ Pf511 Pf5Dose: 1st 2nd Add

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How to fill out covid-19 flu vaccine consent

01

Read through the consent form carefully to understand the information being provided.

02

Fill out your personal information such as name, date of birth, contact information, and any relevant medical history.

03

Sign and date the consent form to indicate your agreement to receive the covid-19 flu vaccine.

04

If necessary, have a guardian or authorized representative fill out and sign the consent form on your behalf.

Who needs covid-19 flu vaccine consent?

01

Anyone who wishes to receive the covid-19 flu vaccine must fill out the consent form. This includes adults, minors, and individuals who may require a guardian or authorized representative to consent on their behalf.

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What is covid-19 flu vaccine consent?

Covid-19 flu vaccine consent is the agreement given by an individual to receive the Covid-19 flu vaccine.

Who is required to file covid-19 flu vaccine consent?

Anyone who wishes to receive the Covid-19 flu vaccine is required to file the consent form.

How to fill out covid-19 flu vaccine consent?

The Covid-19 flu vaccine consent form can be filled out by providing personal information, medical history, and giving consent to receive the vaccine.

What is the purpose of covid-19 flu vaccine consent?

The purpose of Covid-19 flu vaccine consent is to ensure that individuals are fully informed and agree to receive the vaccine.

What information must be reported on covid-19 flu vaccine consent?

The Covid-19 flu vaccine consent form may require personal information, medical history, and consent to receive the vaccine.

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