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CONSENT FOR FLU VACCINE IMMUNIZATION PLEASE COMPLETE BOTH SIDES Name (Print):___ SHIP#: ___ Phone Number: ___ PLEASE NOTE: YOU WILL BE REQUIRED TO WAIT 15 MINUTES IN THE GENERAL VICINITY OF THE NURSE FOLLOWING

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How to fill out consent for flu vaccine

01

Read the consent form carefully and understand the information provided.

02

Fill out your personal information such as name, date of birth, address, and contact information.

03

Check the box to indicate that you understand the risks and benefits of taking the flu vaccine.

04

Sign and date the consent form to acknowledge your agreement to receive the flu vaccine.

05

Return the completed consent form to the healthcare provider administering the flu vaccine.

Who needs consent for flu vaccine?

01

Anyone who wishes to receive the flu vaccine, especially individuals in high-risk groups such as elderly people, young children, pregnant women, and individuals with certain medical conditions.

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What is consent for flu vaccine?

Consent for flu vaccine refers to the formal permission given by an individual or a guardian allowing the administration of the influenza vaccine.

Who is required to file consent for flu vaccine?

Typically, consent is required from individuals receiving the vaccine or their parents/guardians if the individual is a minor.

How to fill out consent for flu vaccine?

To fill out consent for the flu vaccine, obtain the consent form, provide necessary personal information, confirm eligibility, and sign the form.

What is the purpose of consent for flu vaccine?

The purpose of consent for the flu vaccine is to ensure that individuals are informed about the vaccine and agree to its administration.

What information must be reported on consent for flu vaccine?

Required information generally includes the individual's name, date of birth, medical history, and a signature from the consenting party.

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