Flu Vaccine Clinics Consent Form

Find the English Consent Form here.

Find the Spanish Consent Form here.



You may fill out this form electronically, or print the form and scan it.*

Upon filling out the Consent Form, please send the electronic document/scanned document via email to: CommunityOutreachRN@PalomarHealth.org or bring your completed form with you on your scheduled clinic date.


*If you cannot fill out the form electronically, scan the form, or print the form, consent forms will be available to you on the day of your clinic.

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