2018 Influenza Vaccine Consent FormMust be returned to-2026

1. Click ‘Get Form’ to open the 2018 Influenza Vaccine Consent Form in the editor.
2. Begin by filling in your child's legal last name, first name, middle initial, and date of birth. Ensure all required fields marked with an asterisk (*) are completed.
3. Provide the mother's maiden name, mailing address, city, state (NM), zip code, and phone number. This information is crucial for contact purposes.
4. Complete the insurance information section by selecting the appropriate category and providing necessary details such as Medicaid plan or private insurance information.
5. Answer the medical screening questions honestly. If any answers are 'Yes', consult with the school nurse regarding vaccination eligibility.
6. In the consent section, read through the provided information about the vaccine. Sign and date where indicated to give consent for your child’s vaccination.
7. Once completed, save your form and return it using our platform for easy submission to the school nurse.

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