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20232024 Annual Influenza Vaccine Consent Form FLU SHOT THIS FORM MUST BE BROUGHT WITH YOU TO YOUR APPOINTMENT! Section 1: Information about Child to Receive Vaccine (please print) PATIENTS NAME (Last)(First)(M.I.)PATIENTS
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Read the provided instructions or information leaflet before filling out the side effects section.
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List all the side effects experienced after taking the medication, even if they seem minor.
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Side effects are unwanted or unexpected reactions or events that occur after the use of a particular product, especially a medication or treatment.
Healthcare providers, pharmaceutical companies, and regulatory agencies are typically required to report side effects.
Side effects can be filled out on specific reporting forms provided by regulatory agencies or through online reporting systems.
The purpose of reporting side effects is to monitor the safety and effectiveness of products, identify potential risks, and take appropriate actions to protect public health.
Information that must be reported includes the type of side effect, the severity, the patient's characteristics, and any other relevant details.
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