has component is about vaccination procedure injectable influenza vaccination questionnaire for University of Maryland College Park vaccination consent questionnaire for UM College Park injectable influenza vaccination consent http://www.health.umd.edu/sites/default/files/InfluenzaVaccineform2015-2016.pdf question whether currently sick question whether allergic to latex question whether allergic to egg question whether allergic to medication question on reaction after immunization question whether allergic to thimerosal question whether diagnosed with Guillain-Barre syndrome question on fever question whether allergic to egg products question on woman's possibility of geting pregnant