This e-consent link
is for YES to "consent" or NO to "do not consent" for the
recommended adolescent school-aged vaccination for your child, as explained in your letter. This form is for one of the following vaccines.
TETANUS, DIPHTHERIA POLIO (Td/IPV) & MENINGITIS ACWY
These vaccines are routinely given at school in Year 9. They are given at the same time.
Click here for more information on:
- ALL SCHOOL AGE VACCINATIONS
- ADVICE FOLLOWING VACCINATION
- DATA SHARING
- CONSENT INFORMATION
- PORCINE GELATINE
Human Papillomavirus (HPV)
Routinely offered to ALL year 8 Boys & Girls. Catch up available for those in Years 9,10 and 11 who have not received this vaccination.
Patient Information Leaflet
HPV - Information on the HPV vaccination from September 2023 - GOV.UK (www.gov.uk)
Td/IPV) - https://www.medicines.org.uk/emc/product/5581/pil
MENINGITIS ACWY- https://www.medicines.org.uk/emc/files/pil.4118.pdf
You can contact your child’s Immunisation team if you have any questions or need help completing the form:
COVENTRY IMMUNISATION TEAM: Tel: 024 76 961422 Email: Bewise.Immunise@covwarkpt.nhs.uk
SOUTH WARWICKSHIRE IMMUNISATION TEAM: Tel: 01926 353899 Email: SOUTHIMMS@covwarkpt.nhs.uk
NORTH WARWICKSHIRE IMMUNISATION TEAM Tel: 02476 321550 Email: NORTHIMMS@covwarkpt.nhs.uk
**PLEASE NOTE **
By clicking the Continue button at the bottom of this page:
- I confirm that I have parental responsibility for the named child on this form
- I have read and understood the information given to me about the relevant vaccine
- I understand that information provided will be shared with their GP and CHIS.
- I understand the data submitted as part of the e-consent form will be stored safely and securely on Coventry and Warwickshire Partnership Trust systems and only be used for the relevant Vaccination
Yours faithfully
Coventry & Warwickshire Partnership Trust Immunisation Team