has component is about vaccination procedure questionnaire for Manitoba vaccination consent pneumococcal vaccination influenza vaccination question whether currently sick allergy question question on reaction after immunization question on long-term health problem questionare for Manitoba Seasonal Influenza and Pneumococcal vaccination consent http://www.gov.mb.ca/health/flu/docs/flupneumo_consentform.pdf a questionnaire that is part of the vaccination informed consent form used for Seasonal Influenza and Phenumococcal vaccination in Manitoba, Canada.