Consent Form for COVID-19 Vaccination:
Children aged 5 to 11 years
Before you fill out this form, make sure you read the information form by clicking here on the Comirnaty (Pfizer) COVID-19 Vaccine.
If you answered Yes to any of questions 1 to 7, your child may still be able to receive the Pfizer COVID‑19 vaccine, however you should talk to your child’s GP, immunisation specialist or cardiologist first to discuss the best timing of vaccination and whether any additional precautions are needed.
Your Child's Health summary
Parent, Guardian and Emergency Contact
Consent to receive COVID - 19 Vaccine