Free Flu Shot (Influenza) Vaccine Consent Forms (Word | PDF)

In most states, immunization vaccines are mandatory for children before they are allowed to enter school. There are also some jobs that require vaccinations to be up to date before hiring you. When it comes to the flu vaccine, consent must be given before administering the shot due to the side effects it may have. This is done using a Flu Shot (Influenza) Vaccine Consent Form.

Influenza, also known as the flu, is a respiratory illness that is contagious. It is caused by the influenza virus and can infect the throat, nose, and lungs. The disease it causes can range from very mild to severe, and possibly death in the most severe cases. The best flu prevention is to have a flu shot every year.

The influenza vaccine, or flu shot, protect you against the infections that can be caused by the influenza virus. The virus changes rapidly, which is why twice a year, new versions of the flu vaccine are developed.

There are side effects that a patient needs to be made aware of before being given a flu shot. These include:

• Fever
• Headache
• Redness or soreness at the area of the shot
• Muscle aches
• Nausea

More severe side effects that require you to seek medical attention include:

• Having difficulty breathing
• Dizziness
• Hoarseness
• Hives
• Swelling
• Rapid heartbeat

The Flu Shot (Influenza) Vaccine Consent Form is used by nurses and medical practitioners to get authorization to administer the shot by the patient or parents/guardians if the patient is a minor. The form has a series of questions that the practitioner will ask that will determine if a patient should be exempt due to the chance of complications from the shot. It will also list the risks, side effects, and benefits of receiving the shot, and this should be gone over with the patient before the form is signed. The purpose of the form is to not only give the patient the information they need to make an informed decision but to protect the practitioner from liability should complications arise.

Why written consent is important

There are no Federal requirements that informed consent is needed for immunization. However, each state will have its own regulations regarding flu shots. There was some concern over the fact that nurses could give the shot with verbal consent or refusal alone, with many feeling that, without written permission, it left the medical practice open to liability. This is why it is advised that written informed consent be used.

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One situation where flu vaccines are mandatory is in the workplace, and many wonder if it is legal for an employer to require a flu shot in order to remain employed in that company. The flu is very contagious and can infect an entire workforce, which can have a negative impact on a business.

Generally, a business can enforce a policy on getting flu shots. An example is the healthcare industry, which has fired employees for refusing to have a flu jab. Getting a flu vaccination can also be a precondition for being hired. A company must make employees aware of the policy before they are hired. Some companies will pay for their employees to have a shot, and even have a medical provider administer the flu shot on-site.

While an employee has every right to refuse a flu shot, they are not protected, under law, from being fired because a company wishes to have a workforce that has been vaccinated. In some situations, such as a person who works in a union, the flu shot can be refused without them losing their job.

Frequently Asked Questions