Covid Vaccination Consent Confirmation

Further to our recent communication, our NHS colleagues are able to offer COVID vaccinations to pupils aged 5 years and over in school and will visit school on Thursday 25th January 2024, to provide this.

Please complete the form below to confirm your consent for your child to receive the vaccination. The NHS Vaccination team may also contact you to discuss the details of the vaccination.

In the meantime if you have any questions or concerns, please contact Covid19schoolsvaccinationprogramme@gstt.nhs.uk

Please respond by Noon on Monday, 22nd January 2024

Please enter your child's first name* Please enter your child's surname* Please enter your child's date of birth dd/mm/yy* Please enter your child's NHS number (if known)

By ticking this box, I confirm that I give my consent for my child to be vaccinated in school*I consent

Please enter - parent/guardian first name* Please enter - parent/guardian surname* Please enter your contact telephone number*

NOTE: No vaccination will be given without explicit parental consent. By returning this form you are agreeing for GSTT to contact you on the number provided. By ticking this box, I agree to Riverside School sharing my contact details and my child's name and date of birth with GSTT*I agree

Covid Vaccination Consent Confirmation

Cookie Policy