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Click ‘Get Form’ to open the injection log sheet PDF in the editor.
Begin by filling out the 'Quantity' section. Indicate how many injections you are requesting by checking the appropriate box.
Next, select your payment method from the options provided: Invoice, Cash, Check, or Credit Card. Ensure you check the corresponding box for your choice.
In the 'Participant’s Name' field, print your name clearly. If applicable, include your company name in the designated area.
Sign and date the form at the bottom. If you are under 18, a guardian's signature is required.
Fill in your contact information including email and phone numbers for both home and cell.
Select your preferred injection site by checking either Left Deltoid, Right Deltoid, or Other. If 'Other' is selected, specify the site.
Finally, enter the Lot number and Expiration Date of the injection before submitting.

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