H1N1 Parent/Guardian Letters and Consent Forms for School-located Vaccination
Author: Kanawha-Charleston Health Department
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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.
Program: Community Health
Submitted Date: Nov 24, 2009 | Modified Date: Sep 30, 2025
Primary Toolkit: Influenza Toolkit | Secondary Toolkit: Influenza Toolkit
Jurisdiction:
Institution Type: LHD - County,
Keywords: Infectious Disease, Influenza, Maternal, Child, and Adolescent Health, Immunization, School Safety
