Get 2017-2018 Influenza Vaccine Release Form

Filling out the 2017-2018 Influenza Vaccine Release Form online is a straightforward process that ensures you understand the information regarding the influenza vaccine. This guide will help you navigate through the form's sections with clarity and confidence.

Follow the steps to complete the form accurately:

1. Press the ‘Get Form’ button to access the form and open it in your chosen digital environment.
2. Read the introduction carefully. It details the importance of understanding the Vaccine Information Statement regarding the disease and vaccine. Ensure you are informed before proceeding.
3. Provide your personal information in the 'Information about person to receive vaccine' section. Fill in your last name, first name, and initial. Also, include your ASU ID number and date of birth in the specified format (Month/Date/Year).
4. Indicate your employment status by selecting the appropriate option: Faculty/Staff with ASU Insurance, Faculty/Staff Benefits Eligible (Insurance not with ASU), or Faculty/Staff Non-Benefits Eligible with ASU.
5. Answer the provided health questions by checking 'Yes' or 'No.' Each question addresses potential allergies and health conditions. Ensure you answer each question honestly and to the best of your knowledge.
6. In the area labeled 'For clinic/office use,' leave the manufacturer lot number and other related fields blank, as these will be filled out by the health services staff.
7. Choose your preferred site of injection by marking either 'Left' or 'Right' for the deltoid muscle.
8. Lastly, review the form to ensure all information is correct. After validation, proceed to save your changes, download the completed form, print it, or share it as necessary.

Complete your forms online today to streamline your vaccination process.