This page will provide families all they need to consent for the flu vaccine this year. Please review the forms below, fax, email, or mail them to Ruby Jost and we will take care of the rest.

Thank you for partnering with us as we strive to provide the best quality care to your loved ones.

Please review each document and be sure to fax, email, or mail the required forms to our facility. Thank you!

Flu Vaccine Information Sheet

Letter from our Nursing Department

Flu Vaccine Consent Form

Please sign and return the consent form to:
Eagleview Health and Rehabilitation,
Attn: Ruby Jost
849 Big Oak Road, Pittsgrove, NJ 08318

OR you may fax the signed form to the nursing office at (856)459-5934.

For more information about the flu, call 1-800-CDC-INFO or visit or