Consent Form for Flu Vaccine

We will visiting your school in the coming days to give the nasal flu vaccine to children in the school.  We can also give the injectable flu vaccine free of charge to any staff member 18-65 years of age who wishes to have it.  While it doesn't prevent every cough and cold (that you are exposed to on a daily basis!), it does prevent the flu which can be quite nasty and result in being sick for a week or two.

The vaccine is very well tolerated and most people just report that their arm feels a bit bruised at the site of the injection for the rest of the day and they otherwise have no symptoms.  It is not possible to get the flu from the flu vaccine.  It is both safe and important to get the flu vaccine if you are pregnant.  If you wish to read more about it you can visit the following page - Adult Flu Vaccine

In order for us to submit your flu vaccine to the HSE, we need to take a few details and ensure you have no contra-indication to getting the flu vaccine.  Please complete the form below so we don't have to take any personal details on the day.  The "indication" box makes it easier for us to ensure you qualify for a free flu vaccine but submit the form anyway even if none of these apply.