Printable Flu Shot Form

Printable Flu Shot Form - 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 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.

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

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I Consent To Receiving The Seasonal Influenza Vaccine.

Have you ever had a flu shot before? Ask questions and have had them answered to my satisfaction. 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?

Have You Received Any Vaccinations In The Last 6 Weeks?

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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