Flu Shots

Consent Forms

A consent form must be completed and signed by each person before administering any flu shot. The consent form screens the participant for contraindications to the vaccine, acknowledges the VIS has been made available and also collects vaccine information (manufacturer, lot number, etc.).

— Flu Shot Consent Form (English)
— Flu Shot Consent Form (Spanish)
— High-Dose/Adjuvanted Flu Shot Consent Form (English)
— High-Dose/Adjuvanted Flu Shot Consent Form (Spanish)

CDC Vaccine Information Statements

A Vaccine Information Statement (VIS) produced by the CDC must be made available to participants prior to receiving a vaccination.

— Inactivated Flu Vaccine Information Statement (VIS) English
— Inactivated Flu Vaccine Information Statement (VIS) Spanish

Physician Standing Orders and Protocol

The administrating physician order will be included in the event paperwork. These must be reviewed by each administering nurse before the day of the event and brought on-site with you.

— Flu Vaccine & Epinephrine – All states except Georgia
— Flu Vaccine & Epinephrine – Georgia (Fill out in advance)
— Flu Vaccine & Epinephrine – Georgia (Fill out at the event)