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Year 7 Secondary School Vaccine Program Consent Form

How to complete the form

  1. Read the information provided
  2. Complete the vaccine consent section for each vaccine program and type your name to consent to the vaccine
  3. Complete the consent sections even if you do not want your child to be vaccinated

Human papillomavirus (HPV) information

Pre-immunisation checklist

Some children need a three-dose course of Gardasil®9 vaccine.

To ensure your child receives the correct spacing of the three doses, your child must attend their GP or a local council immunisation service.

Three doses of Gardasil®9 vaccine are recommended for:

  • a child aged 15 years or over
  • a child who has a disease or is having treatment which causes low immunity (for example HIV/AIDS, rheumatoid arthritis, cancer, radiotherapy, chemotherapy or significant immunosuppressive treatment).

Before your child is immunised, tell your doctor or nurse if any of the following apply.

  • Is unwell on the day of immunisation (temperature over 38.5°C)
  • Has had a severe reaction to any vaccine
  • Has any severe allergies such as an anaphylactic reaction to yeast
  • Is pregnant.

After vaccination wait at the place of vaccination a minimum of 15 minutes.

Diphtheria, tetanus and whooping cough information

Further information

If you require further advice or information, please contact your local council immunisation service or local doctor.

Or visit the following websites:

Translating and interpreting service call 131 450

Consent form

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