Printable Flu Shot Form

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

In addition, i am aware that. 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. Ask questions and have had them answered to my satisfaction. I consent to receiving the seasonal influenza vaccine. 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?

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Have You Ever Had A Flu Shot Before?

Have you received any vaccinations in the last 6 weeks? I consent to receiving the seasonal influenza vaccine. Ask questions and have had them answered to my satisfaction. 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?

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