Addendum to influenza vaccine 2026

1. Click ‘Get Form’ to open the addendum to the influenza vaccine in the editor.
2. Begin by filling in the name of the person receiving the vaccine in the designated field. Ensure accuracy for proper documentation.
3. In the section labeled 'Vaccine to be given', select 'Inactivated Influenza Vaccine' from the options provided.
4. Complete the 'Information about person to receive vaccine' section by entering their last name, first name, middle initial, birthdate, sex, and address details.
5. Fill in the clinic/office address where the vaccine will be administered, along with additional details such as date of administration and vaccine manufacturer.
6. Ensure that either the recipient or an authorized individual (like a parent or guardian) signs in the appropriate signature field.
7. Finally, have the vaccine administrator sign and date their section to complete the form.

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