H1N1 Parent/Guardian Letters and Consent Forms for School-located Vaccination

Keywords / Description:

This tool is a 3-page PDF document developed by the Kanawha-Charlston Health Department.

The tool provides an example of informational letters and a consent form for school-located H1N1 vaccination clinics.

Kanawha-Charlston Health Department sent these forms home to the parents/guardians of school-age children during their school-located H1N1 vaccination efforts. The H1N1 Vaccine Information Sheet (VIS) for the Live Attenuated Nasal Spray (LAIV) and the Inactivated Flu Shot were also included with this information.

Kanawha-Charleston Health Department was featured as a "Story from the Field" during a Mass Vaccination Clinic Planning Call. The health department credits these letters among the efforts that have led to numerous successful school-located vaccination clinics.

Toolkit:

Influenza Toolkit

Keyword Area:

Child, Immunization, Infectious Diseases, Pandemic Influenza, School

Jurisdiction:

Institutional Author:

Kanawha-Charleston Health Department

Submitted:

11/24/2009

Modified:

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