WebJun 24, 2024 · Create Document. Updated June 24, 2024. A flu shot (influenza) vaccine consent form is a written authorization that gives a nurse or other medical practitioner the go-ahead to administer the flu … WebSee the Template Consent Forms: Annual Influenza Vaccine Consent Form-FLU SHOT; Annual Influenza Vaccine Consent Form-NASAL SPRAY; Annual Influenza Vaccine …

Vaccine Administration Record (VAR)—Informed Consent for …

Web3.Record the site where vaccine was administered as either RA (right arm), LA (left arm), RT (right thigh), LT (left thigh), or NAS (intranasal). 4.Record the publication date of each VIS as well as the date the VIS is given to the patient. 5.To meet the space constraints of this form and federal requirements for WebOct 1, 2024 · 2024-2024 Influenza Vaccination Record In an effort to protect patients, employees, family members, and the community from influenza infection, Inova Health … rcs field manager

Vaccine Administration Record (VAR)—Informed Consent for …

WebMar 31, 2024 · Seasonal Influenza Influenza is a laboratory reportable condition and should be reported within 24 hours of detection by the lab into CDRSS! Influenza (flu) is a contagious respiratory illness caused by influenza. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. WebInfluenza (Flu) According to the Centers for Disease Control and Prevention, more than 18 million Americans became sick with the flu, more than 410,000 were hospitalized and … WebI acknowledge that, depending upon my state’s law, I may prevent, by using a state-approved opt-out form or, as permitted by my state law, an opt-out form (“Opt-Out Form”) furnished ... using the contact information provided in your patient record regarding health and safety matters, such as vaccine reminders. Patient signature: Date ... rcs field days