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Forms and Policies

Seasonal Influenza and Pneumococcal Vaccine Consent Form

This form is used for obtaining permission and collecting relevant client immunization history before administering the seasonal influenza and/or pneumococcal polysaccharide vaccines. This form is applicable to physicians, nurses, and other health professionals providing immunization services. This form is processed by Manitoba Health, Seniors and Active Living.
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Download and PrintFUN-06-R-06-0324.pdf
Department/Crown: Health
Category: Health
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