Printable Flu Shot Form

Printable Flu Shot Form - In addition, i am aware that. I consent to receiving the seasonal influenza vaccine. I hereby consent to the administration of the flu vaccine for which i have signed below be given to me or the person named above for whom i am. Have you ever had a flu shot before? Have you ever had a life threatening allergy to any component (or part) of the flu or pneumonia vaccine? Ask questions and have had them answered to my satisfaction. Have you received any vaccinations in the last 6 weeks?

Ask questions and have had them answered to my satisfaction. Have you received any vaccinations in the last 6 weeks? I consent to receiving the seasonal influenza vaccine. I hereby consent to the administration of the flu vaccine for which i have signed below be given to me or the person named above for whom i am. Have you ever had a flu shot before? Have you ever had a life threatening allergy to any component (or part) of the flu or pneumonia vaccine? In addition, i am aware that.

I hereby consent to the administration of the flu vaccine for which i have signed below be given to me or the person named above for whom i am. Ask questions and have had them answered to my satisfaction. I consent to receiving the seasonal influenza vaccine. Have you ever had a life threatening allergy to any component (or part) of the flu or pneumonia vaccine? In addition, i am aware that. Have you received any vaccinations in the last 6 weeks? Have you ever had a flu shot before?

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Have You Received Any Vaccinations In The Last 6 Weeks?

Have you ever had a life threatening allergy to any component (or part) of the flu or pneumonia vaccine? Ask questions and have had them answered to my satisfaction. Have you ever had a flu shot before? In addition, i am aware that.

I Consent To Receiving The Seasonal Influenza Vaccine.

I hereby consent to the administration of the flu vaccine for which i have signed below be given to me or the person named above for whom i am.

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