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Influenza Immunization Informed Consent - DIGITAL FORM

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$69.95
SKU: 7123E-F25
$69.95

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NOW AVAILABLE - UPDATED FOR 2025-2026 SEASON!

Use this form to document that:

the influenza vaccine was offered to the patient/resident
the required education about the vaccine was provided to the patient/resident (or their representative)
the patient/resident (or their representative) consented to or declined the vaccine

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*SUBSCRIPTION: Form access is licensed for 1-year per agency/facility location. Multiple sites require a quote. 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) and provide the facility/agency address. After 1- year, your subscription will automatically renew.


All Briggs Digital on Demand products require a credit card payment (or pre-payment) to receive digital files electronically.

Briggs Healthcare does not allow use of any of its intellectual property without a valid license and payment of fees.

Delivery: Digital* form-fillable PDF

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

*SUBSCRIPTION: Form access is licensed for 1-year per agency/facility location. Multiple sites require a quote. 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) and provide the facility/agency address. After 1- year, your subscription will automatically renew.


All Briggs Digital on Demand products require a credit card payment(or pre-payment) to receive digital files electronically.

Briggs Healthcare does not allow use of any of its intellectual property without a valid license and payment of fees.

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