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Influenza Immunization Informed Consent

SKU
MPSBRG-7123
In stock
More Information
MPN 7123
Packaging 1 per each
Size 8-1/2In x 11In
$48.66

    Note : Image shown for reference purposes only. Actual product appearance may vary. Please read product description for full and accurate details

    This form provides patient/resident information regarding influenza and is used to document consent or declination of the influenza vaccine. It includes information regarding

         Which populations are at a high risk for complications from influenza
         Clinical Influenza symptoms
         Possible vaccination side effects

    Color: White paper with black ink

    Size: 8-1/2" x 11"

    Hole Punch: 5 holes on top and side

    Printed: 1 side

    Quantity: 100 ea/pd 

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