Start using our platform today to easily complete your INFLUENZA (FLU) VACCINE CONSENT FORM online for free!
| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2018 | 4.8 Satisfied (51 Votes) |
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The form includes questions regarding allergies to eggs or egg products, which is crucial for determining eligibility for the flu vaccine.
It asks if the individual has ever been diagnosed with Guillain Barre syndrome, as this condition may affect vaccine administration.
The form inquires about pregnancy status to ensure safety and appropriateness of the vaccine for pregnant individuals.
Participants are asked about any other allergies to medications or food, which is important for assessing potential risks.
The participant acknowledges they have read information about the vaccine, understand its benefits and risks, and consent to receive it.
The form includes sections for recording the manufacturer, lot number of the vaccine, and site of injection (right or left deltoid).
A signature from a nurse is required on the form to validate that the immunization has been administered properly.
