Influenza Immunization Informed Consent - Employee
$54.57
In stock
Product Code :
MPSBRG-7123S
| Color | White |
|---|---|
| MPN | 7123S |
| Brand | Briggs Health Care |
| Packaging | 1 per each |
| Size | 8-1/2In x 11In |
Note : Image shown for reference purposes only. Actual product appearance may vary. Please read product description for full and accurate details.
This form provides employees 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
The Vaccine Information Statement (VIS) as allows providers to
designate the type of vaccine administered: standard trivalent, high dose
trivalent or quadrivalent.
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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