Resources for Healthcare Professionals

Planning Clinics and Campaigns

Vaccine Dosage and Administration

Storage and Handling

Model Standing Orders

Screening Forms, Consent Forms, and Other Important Documents

  • Flu Consent and Screening Combined  pdf format of Flu Consent and Screening Combined
docx format of                             Flu Consent and Screening Combined
    • MDPH created sample influenza vaccine consent and screening forms for both IIV or LAIV formulations.  Such forms are intended to be used in settings where children are being vaccinated and the parent/legal guardian is NOT present.   Such setting might include, but are not limited to, school-based clinics, public clinics, or visits to practices when the child is unaccompanied by their parent/legal guardian and no other general consent to treat are in place.
  • Flu Consent LAIV  pdf format of Flu Consent LAIV
docx format of                             Flu Consent LAIV
    • MDPH created sample influenza vaccine consent and screening forms for both IIV or LAIV formulations.  Such forms are intended to be used in settings where children are being vaccinated and the parent/legal guardian is NOT present. Such setting might include, but are not limited to, school-based clinics, public clinics, or visits to practices when the child is unaccompanied by their parent/legal guardian and no other general consent to treat are in place.
  • Flu Consent IIV  pdf format of Flu Consent IIV
docx format of                             Flu Consent IIV
    • MDPH created sample influenza vaccine consent and screening forms for both IIV or LAIV formulations. Such forms are intended to be used in settings where children are being vaccinated and the parent/legal guardian is NOT present. Such setting might include, but are not limited to, school-based clinics, public clinics, or visits to practices when the child is unaccompanied by their parent/legal guardian and no other general consent to treat are in place.

Influenza Vaccination of Healthcare Personnel (HCP)

For up-to-date information for health care providers, please call the MDPH Division of Epidemiology and Immunization at 617-983-6800 or toll free at 888-658-2850.


This information is provided by within the Department of Public Health.