Get Kaiser Permanente Flu Shot Form Signed

Filling out the Kaiser Permanente Flu Shot Form Signed online is a straightforward process that allows users to easily document their flu vaccination status. This guide will provide clear instructions to ensure that you complete the form accurately and effectively.

Follow the steps to successfully complete the flu shot form online.

1. Press the ‘Get Form’ button to download the form and open it in your device's editor.
2. Begin by entering your name in the designated field at the top of the form.
3. Fill in your department to indicate your workplace affiliation.
4. Provide your medical record number, if available, to facilitate identification.
5. Enter your employee number to link your vaccination record with your employment.
6. Indicate whether you received the flu vaccine by selecting either ‘Injection’ or ‘Nasal spray’.
7. Document the approximate date when you received the vaccine in the given space.
8. If you do not wish to receive the flu vaccine, check the box provided and proceed to read the acknowledgment.
9. After reading, acknowledge your understanding by signing and dating the form.
10. If you are declining vaccination, check the appropriate reasons for your decision, noting any specific reasons if applicable.
11. Sign and date the final section to affirm your declaration.
12. Once completed, save your changes, and you may choose to download, print, or share the form as necessary.

Complete the Kaiser Permanente Flu Shot Form Signed online today to ensure your vaccination status is recorded.