Influenza Immunization Informed Consent
$54.57
In stock
Product Code :
MPSBRG-7123
| Color | White |
|---|---|
| MPN | 7123 |
| 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 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
Write Your Own Review
WARNING: There are products on this website which can expose you to chemicals known to the State of California to cause cancer and birth defects or other reproductive harm. For more information go to 