• Home
  • Influenza Immunization Informed Consent - Employee - DIGITAL FORM

Influenza Immunization Informed Consent - Employee - DIGITAL FORM

(0) No Reviews yet
$69.95
SKU: 7123SE
$69.95

Electronically Delivered eForm* - Available Now – Subscribe Today!

Briggs Digital forms:

-Updates included with annual subscription
-Form-fillable PDF documents at your fingertips
-Easy to complete on any device


UPDATED SEPTEMBER 2023

Briggs Influenza Immunization Informed Consent provides the employee with information regarding influenza and is used to document consent or declination of the influenza vaccine. It includes information regarding:

Hospitalization and deaths based on age

Populations that are at high risk for complications from influenza

Clinical influenza symptoms

Possible vaccination side effects

Important new information from CDC/ACIP that recommends the vaccine to individuals with egg-allergy

The Vaccine Information Statement (VIS) section of this form allows providers to designate the type of vaccine administered as Quadrivalent for the current flu season. It also provides the web address to the FDA Fact Sheets for provision to the employee as part of the education for informed consent.

Download a sample today!

License Agreement

Send completed License Agreements toCustomerSupport@BriggsCorp.com

*This digital form is delivered as a form-fillable PDF and includes 1-year of updates. To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery (please allow 2-3 business days for order fulfillment). After 1- year, your update subscription will automatically renew.

Delivery:  Digital* 

Digital/electronic merchandise & subscriptions: all digital and electronic products and subscriptions are non-refundable and non-returnable


*This digital form is delivered as a form-fillable PDF and includes 1-year of updates.   To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery (please allow 2-3 business days for order fulfillment).  After 1- year, your update subscription will automatically renew.

Ratings & Reviews

No reviews available

Be the first to Write a Review