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Vaccine Information Statement: Attenuated Influenza Vaccine, Live ... - www2 laconiaschools 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out Section 1 with the student's information, including their name, date of birth, and grade. Ensure all fields are completed accurately.
- In Section 2, provide health insurance details. If your child has no insurance, select the appropriate option. This information is for data purposes only.
- Proceed to Section 3 to screen for vaccine eligibility. Answer each question honestly; if any 'YES' responses are given in Section 3-A, consult your child's doctor.
- In Section 4, indicate your consent for vaccination by signing and dating the form. Choose between injectable or nasal vaccine based on eligibility.
- Review all sections before submitting the form to ensure completeness and accuracy.
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