Influenza Immunization Informed Consent

$48.66
In stock
Product Code :
MPSBRG-7123
More Information
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 

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