Injectible Vaccine Consent (Flu Shot)

Flu Clinic Information:
It is not too late to sign your student up to receive this years Influenza Vaccine !!  The new date for our Flu Clinic here at WLMS is Tuesday, October 17th .  Paper consent forms are being sent home with students and are due back no later than Wednesday, October 11th  .    Please complete it in it’s entirety and do not forget to sign!
What IF’s:
• IF you have already submitted an electronic consent form, you do NOT need to complete a paper form.  
• IF you have completed a paper form already, you do NOT need to re-submit.
• IF  you believe you have done one of the above and you want to make sure that your child is already signed up to receive the vaccine OR if you have any questions please call the Health Room at 410-313-6957.


Influenza, also known as the flu, is a serious illness that affects people of all ages.  One of the best ways to prevent the flu is through vaccinations.  We are pleased to again join with the Maryland Partnership for Prevention (MPP) to offer flu vaccinations at our school.

New this year, you may give permission for your child to be vaccinated using the attached form.

We urge you to protect your family from the flu. The Centers for Disease Control and Prevention (CDC) recommends that everyone ages 6 months and older get a flu shot. Please visit for more information about the flu vaccine.

The clinic at our school will be held in October.  We will send a notice home the day your student has been vaccinated indicating receipt of flu vaccine.

 If you want your child to be vaccinated, please:

1.    Fill out every section of the attached Consent Form Write neatly and use ink. 

2.    Use your insurance card to fill out your insurance information accurately.  Your insurance company will be billed.  There is no co-pay or deductible.  You will NOT be charged by us or your insurance company.

3.    Read the Vaccine Information Statement (VIS) and talk to your health care provider or the school nurse about any questions you have.

4.    Return the consent form

To complete the consent form:

PDF icon2017-18 Howard Co SLIV ENGLISH Consent Packet - FINAL.pdf

PDF icon2017-18 Howard County SLIV SPANISH Consent Packet - FINAL.pdf


Tuesday, October 17, 2017 (All day)