ARIZONA STATE UNIVERSITYEMPLOYEE FLU CONSENT 2019-2026

1. Click ‘Get Form’ to open the ARIZONA STATE UNIVERSITY EMPLOYEE FLU CONSENT 2019 in the editor.
2. Begin by reading the information about the influenza vaccine carefully. Ensure you understand the conditions under which you should not receive the vaccine.
3. Fill in today’s date in the designated field, ensuring it is formatted as MM/DD/YY.
4. Provide your signature in the specified area to indicate your consent for receiving the vaccine.
5. Complete the section labeled 'INFORMATION ON PERSON TO RECEIVE VACCINE' by entering their name, date of birth, sex, age, mailing address, city, state, zip code, and phone number.
6. In the 'ASU EMPLOYEE INFORMATION' section, enter your campus ID number and select your insurance carrier from the provided options.
7. Select your preferred vaccine option by checking the appropriate box for Quadrivalent Flu.
8. Finally, ensure all fields are filled accurately before saving or submitting your completed form through our platform.

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