Jai Medical Centre (Brent)

 

Staglane Location: 82 Stag Lane, Edgware, HA8 5LP | Tel: 0300 033 7863 | 020 8952 8583

Current time is 22:10 - Sorry, we're closed

Sheldon Location: 19 Chichele Road, London, NW2 3AH | Tel: 0300 033 7864 | 0300 033 5816

Current time is 22:10 - Sorry, we're closed

NHS

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:

Flu Vaccination Consent form

Electronic Consent form
  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

Jai Medical
(Brent)

  • Monday
    08:00 until 18:30
  • Tuesday
    08:00 until 18:30
  • Wednesday
    08:00 until 18:30
  • Thursday
    08:00 until 18:30
  • Friday
    08:00 until 18:30
  • Saturday
    CLOSED
  • Sunday
    CLOSED

Jai Medical (Sheldon)

  • Monday
    08:00 until 18:30
  • Tuesday
    08:00 until 18:30
  • Wednesday
    08:00 until 18:30
  • Thursday
    08:00 until 18:30
  • Friday
    08:00 until 18:30
  • Saturday
    CLOSED
  • Sunday
    CLOSED