has component questionnaire for Manitoba vaccination consent YH, YL We may also model the Minatoba Child Informed Consent form: http://www.gov.mb.ca/health/publichealth/cdc/div/docs/7707.pdf a questionnaire that is part of the Manitoba vaccination informed consent form. vaccination screening questionnaire question whether currently sick allergy question question whether allergic to egg question on reaction after immunization question on long-term health problem question on any medication affecting blood clotting