Childs Details GP Details Your Details About the Immunisation Confirmation
The Consent Form is not currently open for this school.
Please contact the immunisation team on 0333 358 3397

Please do not take your child to your Doctor to have this vaccine if you are giving consent for them to have it in school.

YES, I consent for my child to receive the Flu immunisation

Consent form for Mayfield Primary School (from September 2023)

Child's Details

please tell us about the child to be vaccinated

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GP Details

please tell us about the your child's GP

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Your Details

As Parent/Guardian we need the following information from yourself

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It is important to give a valid phone and email to ensure your child receives the best care.

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About the Immunisation

Please confirm the following important information about the immunsuation

Confirmation

Please complete the final step to show you understand and consent to the immunisation

Informed Consent
Your Acceptance

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