Printable Flu Shot Form

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

Ask questions and have had them answered to my satisfaction. 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? In addition, i am aware that. Have you ever had a flu shot before? 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. 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 received any vaccinations in the last 6 weeks? Ask questions and have had them answered to my satisfaction. I consent to receiving the seasonal influenza vaccine. In addition, i am aware that. Have you ever had a life threatening allergy to any component (or part) of the flu or pneumonia vaccine?

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In Addition, I Am Aware That.

Have you ever had a life threatening allergy to any component (or part) of the flu or pneumonia 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? I consent to receiving the seasonal influenza vaccine.

Ask Questions And Have Had Them Answered To My Satisfaction.

Have you received any vaccinations in the last 6 weeks?

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