Influenza Vaccine Consent Form

Form Template

Shots are available to the general public for vaccine-preventable diseases.

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For example, the seasonal influenza vaccine (also known as the ""flu shot"") can prevent people from contracting the flu and is available at most health care facilities and pharmacies. While health care insurance typically covers the cost of the influenza vaccine, before the vaccine can be administered, the patient must sign off on a consent form.

This Influenza Vaccine Consent Form mobile app from Inova Health System allows you to collect consent information and signatures for the influenza vaccine. It marks the patient’s granted permission to be given the listed vaccine(s), and also includes a declaration about past or present allergies, allergic reactions and sicknesses. There are screens available for personal information, date, signature and payment method.

Use the Influenza Vaccine Consent Form mobile app at your health care facility or pharmacy to see just how simple it is. This is a great way to streamline your health care documents.

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