Influenza Vaccination Consent Form pls return by 27 Oct, 2020

Please see a copy of the email that sent to parents who have sign up for their child’s free flu vaccine before 16 October.

Click to read in Chinese

Dear parents,

The influenza vaccine for students is scheduled to be administered at The Tian Zhu CDC Hospital during November. We attach examples of two versions of the informed consent forms:

A Chinese version ( white and blue—Attached Template 1 and Template 2) and an English version (two white forms, one with number sticker code in the right upper corner of the headline --- Attached Template 3 and Template 4).

The paper copy will be handed to your child/ren on Friday 23^rd October.  It is necessary that you fill in the Chinese version OR the English version of the informed consent form ( student’s name , parent’s/guardian’s signature, date). That means you need to return both Chinese and English Version consent but only need to sign ONE of them.

Attachments:  

Please read the informed consent carefully, use a black pen, sign the informed consent and add the date (YYYY/MM/DD).

To ensure a safe vaccination, please read carefully whether any medical conditions apply to your child, and if so, please tick / complete accordingly.

• Template 1 Chinese – Return to Nurse. Please fill out requirements (see example on the template) and return this white Chinese version back to School Nurse office.
• Template 2 Chinese – Parent Keep. You can keep the Blue paper.
• Template 3 English – Return to Nurse. Please fill out requirements (see example on the template) on this white English version with code sticker in the headline and return to Nurse.
• Template 4 English – Parent Keep. You can keep this version which is WITHOUT code sticker in the headline.

Reinforce:

Please hand in the white Chinese Version Consent (Template 1) and the white English Version Consent form WITH code sticker (Template 3), you can choose to sign anyone of them, but you need to return both forms.

Please return the two forms BY October 27^th 2020 (next Tuesday).

We have not yet been given an exact date when the vaccination will take place, but will keep you updated the moment we know.

Please also note the general precautions for (influenza) vaccinations:

No student shall be vaccinated in case the show or complain of any symptoms that indicate the onset or ongoing of any acute sickness. After vaccination it is recommended not to bath or exercise vigorously within 24 hours.

If there are special circumstances you can always contact our telephone or email consultation:

Phone: +86 (0)10 8047 3562/ 8047 3519

Email：nursesy@britishschool.org.cn            

www.bsbshunyi.com