The completion of this form is necessary for every vaccine ...
Fluzone High Dose (IIV3-HD) Sanofi Pasteur 0.5 No Yes IM R Arm /L Arm. For Clinic/Office Use Only: Signature of Vaccine Administrator: _____ For children 18 years of age and younger: A. The following questions will help determine if the person to be vaccinated can get the 2018-2019 influenza vaccine. YES NO 1. Does the person to be vaccinated ... ................
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