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H1N1 INFLUENZA VACCINE (SHOT) CONSENT/DECLINATION FORM. The H1N1 influenza vaccine is offered free of charge as a benefit to all employees, volunteers and students who qualify for vaccination based on CDC/APIC recommendations about who should get vaccinated this flu season.
2009 H1N1 Influenza Vaccine Consent Form for Use With Either Intramuscular, Injectable Formulation or Live Attenuated, Intranasal Formulation of Vaccine Author Centers for Disease Control and Prevention (CDC)
Influenza (flu) is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. View All. Learn about flu, including symptoms, prevention methods, and treatment options.
This document is intended to inform you of the upcoming vaccination campaign and ask for your signed consent. After reading the following information , please fill out the vaccination consent form and return it to school. Thank you very much for your cooperation and support.
14 Μαρ 2024 · FluMist contains weakened live influenza viruses. FluMist has the same vaccine virus components as other flu vaccines and will protect against an H1N1 virus, and an H3N2 virus, and an influenza B virus.
CONSENT FORM FOR SEASONAL INFLUENZA (FLU) VACCINE. I have read or have had explained to me the information about influenza and influenza vaccine. I have had an opportunity to discuss the benefits and risks of influenza vaccine with a healthcare provider of my choice before coming here today.
Phone: Section 2: Consent. CONSENT FOR CHILD’S VACCINATION: I have read or had explained to me the Vaccine Information Statement for the influenza vaccine and understand the risks and benefits. I GIVE CONSENT. for my child named at the top of this form to get vaccinated with this vaccine.
