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Western Washington University Student Health CenterQuestionnaire and Consent for Immunizations Please Print NAME: ___ Student Number: ___ Birthdate: ___Please answer the following questions by checking
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Start by carefully reading each question in the questionnaire.
02
Fill in the information requested in each field accurately and honestly.
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If there are any sections that you are unsure about or do not understand, seek clarification from the person providing the questionnaire.
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Review your answers to ensure they are complete and correct before signing the consent form.
05
Sign and date the consent form to indicate your agreement to participate and provide the necessary information.

Who needs questionnaire and consent for?

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Questionnaire and consent forms are typically needed by researchers, healthcare professionals, employers, and organizations when gathering information from individuals for various purposes such as research studies, medical treatment, employment screening, or participation in events or programs.
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A questionnaire and consent form is a document used to gather information from individuals while obtaining their consent to participate in a study or provide certain information.
Individuals or entities participating in research studies or assessments that require the collection of personal data typically need to file a questionnaire and consent.
To fill out a questionnaire and consent form, carefully read the instructions provided, complete the necessary fields with accurate information, and sign where required to indicate consent.
The purpose is to obtain informed consent from participants and collect relevant data for research, surveys, or assessments.
Typically, personal information, demographic data, and any specific questions related to the study's goals must be reported.
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