Consent
Coventry and Warwickshire Partnership Trust Logo
Consent form Please read and accept the information below before we can continue to the form

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. 

                     

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.

 Click here for more information on:

  • ALL SCHOOL AGE VACCINATIONS
  • ADVICE FOLLOWING VACCINATION
  • DATA SHARING
  • CONSENT INFORMATION
  • PORCINE GELATINE

Patient Information Leaflet

HPV - Information on the HPV vaccination from September 2023 - GOV.UK (www.gov.uk) 

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

 

By clicking continue, you are agreeing to the terms set out above