Injectable Vaccine Consent Letter

Influenza, also known as the flu, is a serious illness that affects people of all ages.  One of the best ways to prevent the flu is through vaccinations.  We are pleased to again join with the Maryland Partnership for Prevention (MPP) to offer flu vaccinations at our school.

 

New this year, you may give permission for your child to be vaccinated using (1) an online form at www.vaccineconsent.com or (2) this hard copy form: 2017-18 Howard Co SLIV ENGLISH Consent Packet.

 

We urge you to protect your family from the flu. The Centers for Disease Control and Prevention (CDC) recommends that everyone ages 6 months and older get a flu shot. Please visit www.cdc.gov/flu/index.htm for more information about the flu vaccine.

 

The clinic at our school will be held on SEPTEMBER 26, 2017.  We will send a notice home the day your student has been vaccinated indicating receipt of flu vaccine. 

 

 If you want your child to be vaccinated, please:

 

1.    Fill out every section of the attached Consent Form OR complete it online at www.vaccineconsent.com.  If you fill out the paper consent, write neatly and use ink.  Only fill out the hard copy consent or the online consent.  Do NOT fill out both.

 

2.    Use your insurance card to fill out your insurance information accurately.  Your insurance company will be billed.  There is no co-pay or deductible.  You will NOT be charged by us or your insurance company. 

 

3.    Read the Vaccine Information Statement (VIS) and talk to your health care provider or the school nurse about any questions you have.

 

4.    Return the consent form no later than September 20, 2017.

 

To complete the consent form online, go to:

www.vaccineconsent.com

Date

Tuesday, September 12, 2017 - 11:00am