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Web influenza vaccine consent form. Have you ever had an allergic reaction to. A flu shot (influenza) vaccine consent form is a written authorization that gives a nurse or. Patient record of influenza vaccination consent/declination. Web i authorize the release of any medical or other information necessary to process a medicare or other insurance claim or for. Influenza (flu) is a contagious disease that is caused by the influenza. Web received and read the vaccine information sheet (dated 7/24/08) regarding the benefits and risks of receiving the influenza. The influenza virus vaccine is.