Consent 2020/21 Flu Vaccination

Information about the 2020/21 Flu Vaccination

Flu vaccination Consent form

I, the undersigned have read the information below and hereby give consent to have the flu vaccine, I also confirm that the following apply:

• I am NOT allergic to egg or chicken protein
• I am NOT allergic to antibiotics (neomycin or polymycin)
• I am NOT allergic to mercury compound (thiormersal)
• I do NOT have a fever or think that I may be getting a fever
• I have NOT had a serious reaction to any flu vaccine in the past

For more information on flu-influenza vaccine please click on the link

or you may complete the online consent form: