2024/25 Seasonal Influenza Vaccination (SIV) School Outreach (Free of Charge) Programme - Frequently Used Forms for Participating Schools

Enrolment &
Selection of Doctor/ Medical Organisation

- For Kindergarten/Child Care Centre
Enrolment Form
Supplementary Form

- For Primary School
Enrolment Form
Supplementary Form

- For Secondary School
Enrolment Form
Supplementary Form

Before vaccination

SIVSO_S_A1(KG)

SIVSO_S_A1(PS)

SIVSO_S_A1(SS)

The Number of Students Consented to Vaccination of Each Class
- For KG/ CCC

- For Primary School

- For Secondary School

SIVSO_S_A2

Notice to Parents One Week before the First Dose of Vaccination Day

-Sample For Primary School & KG/CCC

-Sample For Secondary School

SIVSO_S_A3

Notice to Parents One Week before the Second Dose of Vaccination Day (Sample)

SIVSO_S_A4

SIVSO_S_A4(LAIV)

SIVSO_S_A4_Sec

Seasonal Influenza Vaccine Consent Form (For KG/CCC and Primary School)

- Injectable Vaccine

- Nasal Spray Vaccine

-Seasonal Influenza Vaccine Consent Form (For Secondary School)

SIVSO_S_A4

SIVSO_S_A4(LAIV)

SIVSO_S_A4_Sec

Consent Form Sample

- Injectable Vaccine

- Nasal Spray Vaccine

-Seasonal Influenza Vaccine Consent Form (For Secondary School)

SIVSO_D_A2

Consent Forms Receipt Note

During vaccination

SIVSO_S_B1

List of Students Withheld Seasonal Influenza Vaccination

SIVSO_D_C2

SIVSO_D_C2(LAIV)

Seasonal Influenza Vaccine Information on Side Effects

- Injectable Vaccine

- Nasal Spray Vaccine

SIVSO_D_C2(2^nd)

Seasonal Influenza Vaccine Information on Side Effects and 2^nd Dose Arrangement

- Injectable Vaccine