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Consent Form for Nasal Flu Vaccine

A GP will be coming to Young World Creche next Monday 25th Nov at 16:30 to offer the nasal flu vaccine (free of charge) to any children (> 2 years of age) whose parents wish them to have it. 

It is a simple squirt of liquid up each nostril (no needles!) that children usually don't mind and greatly reduces their risk of getting the flu over the winter period as well as reducing the risk of needing to take time off school, parents needing to take time off work and potentially passing flu on to older or vulnerable relatives and contacts.

If you would like us to give your child the nasal flu vaccine when we come to the creche, please enter your child's details below, ensure there are no reasons your child cannot receive the vaccine, sign your name and press submit.  If your child has the vaccine elsewhere after you submit this form or happens to have a fever (>38C) in the 48 hours before the planned vaccination, please advise their teacher and we will not give the vaccine.  It is ok for them to have it if they have a cold (as all our kids do at the moment!).

If your child has never had a flu vaccine before and has a chronic medical condition such as chronic heart / kidney / liver / neurological / respiratory disease, diabetes or Down Syndrome, they may need a second dose of flu vaccine.  Please discuss with your own GP.

Please submit a separate application for each child you wish to have the nasal flu vaccine if you have more than one child in the school.

Please see the following link for information about the nasal flu vaccine and post vaccine care.

Birthday
Day
Month
Year

Please read carefully to ensure none of the following apply to your child. If you tick any of the following boxes as applying, it would not be safe to proceed with vaccination. Please do not proceed with booking and contact your own GP to discuss further.

Relationship to Child
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