Public Health Infrastructure and Systems
Public Health Preparedness
Health Equity and Social Justice
Peer Assistance Network
Legislative Resources and Information
Congressional Action Network
Public Health Logo
News from Washington
Legislative Action Center
LHDs in the News
Help / Request a Tool
My Bookmarked Tools
Submit a Tool
Return to Toolbox Main.
H1N1 Parent/Guardian Letters and Consent Forms for School-located Vaccination
Login to download this tool
Login to Bookmark Tool
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.
Child, Immunization, Infectious Diseases, Pandemic Influenza, School
Kanawha-Charleston Health Department
The NACCHO Toolbox is a repository of available resources to help local public health practitioners. Tools are produced by local, state, and federal agencies, as well as academic institutions and other stakeholders. The contents of this Toolbox are solely the responsibility of the authors and do not necessarily reflect any official recommendations of NACCHO. NACCHO makes no express or implied warranty with respect to the contents and disclaims liability for any damages arising from or connected to the use of the material in this Toolbox.