Consent Forms

Did your employee miss their scheduled flu shot? Would like to send them to us? Please print the authorization slip and select what service you would like us to provide. Also please select who is responsible for payment of the service(s) selected. Star Medical Group / FluShots of America Authorization Form

English Consent Forms

Methylcobalamin Vitamin B12

Influenza “Flu” – Includes Trivalent, Quadrivalent, Flu Mist, Preservative Free and High Dose options

Pneumonia

Hepatitis A

Hepatitis B

TDaP

Typhoid

Zostavax-Shingles Vaccine

Meningococcal

To access the Vaccine Information Sheets for each of the immunizations listed (with the exception of Vitamin B12), please click here to be relocated to the Center for Disease Control (CDC) website. These forms must be read before immunizations can be administered.

Spanish Consent Forms

Methylcobalamin Vitamin B12

Influenza “FLU”

Pneumonia 

Hepatitis A

Hepatitis B