ME York Hospital Patient Influenza Vaccine Consent 2023-2025 free printable template

15 Hospital Drive, York, ME 03909PATIENT INFLUENZA VACCINE CONSENT 202324 [Inactivated] Influenza 1. Are you over the age of 65? 2. Do you have a severe allergy to hens eggs? YES NO YES NO3. Have

How to fill out york-hospital-patient-influenza-vaccine-consent

How to fill out ME York Hospital Patient Influenza Vaccine Consent

1. Begin by reading the consent form carefully to understand its purpose.
2. Fill in your personal details, including your name, date of birth, and contact information at the top of the form.
3. Indicate whether you have had a flu vaccine before by checking the appropriate box.
4. Provide information about any allergies, particularly to eggs or latex, as this may affect your eligibility for the vaccine.
5. Review the section on potential risks and benefits of the influenza vaccine.
6. Sign and date the consent form at the bottom to indicate your agreement to receive the vaccine.
7. Submit the completed form to the healthcare provider or designated staff at ME York Hospital.

Who needs ME York Hospital Patient Influenza Vaccine Consent?

1. Individuals aged 6 months and older who are seeking the influenza vaccine.
2. Patients with chronic health conditions, pregnant individuals, and elderly people should prioritize filling out the consent form.
3. Healthcare workers and caregivers who are in close contact with high-risk individuals also need to complete the consent.

People Also Ask about

Who determines the flu vaccine?

In the United States, the Food and Drug Administration (FDA)'s Vaccines and Related Biological Products Advisory Committee (VRBPAC) makes the final decision about vaccine viruses for domestic flu vaccines.

Is the flu vaccine regulated by the FDA?

The flu vaccines are approved by the FDA for the prevention of influenza disease, so getting vaccinated can help keep you out of the doctor's office and preserve health care resources for patients with other diseases and medical conditions, including COVID-19.

Who produces the flu vaccine for the United States?

Fluzone and its quadrivalent formulation are split virus inactivated vaccines distributed by Sanofi Pasteur mainly in the United States.

Why do healthcare workers decline influenza vaccine?

Despite all the evidence, 9.57% (9/94) of the HCWs reported that they opt out of flu immunisation as they believe that they do not need the flu vaccine and 13.83% (13/94) of HCWs do not believe in the effectiveness of the flu vaccine and therefore refuse to take it.

What are valid reasons to decline the flu shot?

Children younger than 6 months of age are too young to get a flu shot. People with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins) should not get that vaccine. This might include gelatin, antibiotics, or other ingredients.

Who regulates the flu vaccine?

The Food and Drug Administration (FDA) is responsible for regulating vaccines in the United States.

For pdfFiller’s FAQs

How can I send york-hospital-patient-influenza-vaccine-consent to be eSigned by others?

Once your york-hospital-patient-influenza-vaccine-consent is ready, you can securely share it with recipients and collect eSignatures in a few clicks with pdfFiller. You can send a PDF by email, text message, fax, USPS mail, or notarize it online - right from your account. Create an account now and try it yourself.

Can I sign the york-hospital-patient-influenza-vaccine-consent electronically in Chrome?

As a PDF editor and form builder, pdfFiller has a lot of features. It also has a powerful e-signature tool that you can add to your Chrome browser. With our extension, you can type, draw, or take a picture of your signature with your webcam to make your legally-binding eSignature. Choose how you want to sign your york-hospital-patient-influenza-vaccine-consent and you'll be done in minutes.

How do I complete york-hospital-patient-influenza-vaccine-consent on an Android device?

On an Android device, use the pdfFiller mobile app to finish your york-hospital-patient-influenza-vaccine-consent. The program allows you to execute all necessary document management operations, such as adding, editing, and removing text, signing, annotating, and more. You only need a smartphone and an internet connection.

What is ME York Hospital Patient Influenza Vaccine Consent?

ME York Hospital Patient Influenza Vaccine Consent is a document that grants permission for a patient to receive the influenza vaccine at ME York Hospital.

Who is required to file ME York Hospital Patient Influenza Vaccine Consent?

Patients or their legal guardians are required to file the ME York Hospital Patient Influenza Vaccine Consent before receiving the influenza vaccine.

How to fill out ME York Hospital Patient Influenza Vaccine Consent?

To fill out the ME York Hospital Patient Influenza Vaccine Consent, patients should provide personal information, sign to indicate consent, and complete any additional required sections regarding health history.

What is the purpose of ME York Hospital Patient Influenza Vaccine Consent?

The purpose of the ME York Hospital Patient Influenza Vaccine Consent is to inform patients about the vaccine, its benefits and risks, and to legally document their consent for vaccination.

What information must be reported on ME York Hospital Patient Influenza Vaccine Consent?

The information that must be reported includes the patient's personal details, medical history relevant to the vaccine, and any known allergies or contraindications.