Flu Vaccine Consent Form For Employees
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Web influenza consent statement i have read the centers for disease control vaccine information statement: Name:(last) (first) umid# date of birth (e.g., 1/2/1972) job title or position: For state and local regulations, check with your local. Insurance status * children age 18 and under in starred categories are eligible for vaccines for children. I am taking this vaccine voluntarily and.
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Web Complete The Consent Form When You Are Ready To Upload Your Documentation.
Web influenza consent statement i have read the centers for disease control vaccine information statement: I am taking this vaccine voluntarily and consent to the vaccination being given to me. • keep you from getting flu, • make flu less severe if you do get it, and • keep you from spreading flu to your family and other people. Web please complete the following actions to process this form:
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