Get Flu Shot Form

Completing the Flu Shot Form online is a straightforward process that allows you to document your flu vaccination and receive rewards points. This guide will walk you through each section of the form to ensure all necessary information is provided accurately.

Follow the steps to complete the Flu Shot Form online.

1. Click the ‘Get Form’ button to access the Flu Shot Form and open it in your preferred online editor.
2. Locate the section for Employee Name. Enter your full name as it appears on your official documents.
3. Find the Date of Birth field. Input your date of birth in the format MM/DD/YYYY.
4. Proceed to the Date Vaccination Received section. Fill in the date you received your flu vaccination.
5. In the Administered By field, provide the name of the clinic, pharmacy, or healthcare provider who administered the vaccination.
6. Next, include the Administrator Signature where required. If necessary, get the signature from the administering healthcare provider.
7. The My below signature section requires you to sign, verifying that all provided information is accurate and consenting to the release of your medical information to American Trim. Sign the document here.
8. Finally, review all fields for accuracy, save any changes you've made, and choose an option to download, print, or share the completed Flu Shot Form.

Start filling out your Flu Shot Form online today to ensure you receive your rewards points for your vaccination.