Flu Immunisation Consent Form

Should you have any questions you can contact the Immunisation Team by phone 0300 421 8140, or by email glos-care.immunisationteam@nhs.net

The nasal flu vaccine contains products derived from pigs (porcine gelatine). If the vaccine is refused due to this content, only children who are at high risk from flu due to a medical condition will be offered an alternative injected vaccine. More information is available from www.nhs.uk/child-flu-FAQ

Child information and contact details

Please select "Other" if the GP practice is not listed

Medical information

Parent/Carer information and consent declaration