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Please turn in form to your building receptionist. COMPLETE ALL INFORMATION Vaccine Form Legal NameConsent Only Please Print in blue or black ink only. (No pencil)Lamar County Health Department20232024

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How to fill out 2023-2024 flu vaccine consent

01

First, read the consent form thoroughly to understand the information and requirements.

02

Fill out all personal information accurately, including name, date of birth, and contact information.

03

Indicate any relevant medical conditions or allergies that may affect the administration of the flu vaccine.

04

Sign and date the consent form to verify your agreement and understanding of the terms and conditions.

Who needs 2023-2024 flu vaccine consent?

01

Anyone planning to receive the 2023-2024 flu vaccine at a healthcare facility or clinic.

02

Minors under the age of 18 who require parental consent for medical procedures.

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What is flu vaccine consent form?

The flu vaccine consent form is a document that gives permission to receive the flu vaccine.

Who is required to file flu vaccine consent form?

Individuals who wish to receive the flu vaccine are required to fill out the flu vaccine consent form.

How to fill out flu vaccine consent form?

To fill out the flu vaccine consent form, one must provide personal information and sign the document to give consent for the flu vaccine.

What is the purpose of flu vaccine consent form?

The purpose of the flu vaccine consent form is to ensure that individuals understand the risks and benefits of the flu vaccine and give their informed consent to receive it.

What information must be reported on flu vaccine consent form?

The flu vaccine consent form typically requires information such as name, date of birth, medical history, and contact information.

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