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2023/24 Seasonal Influenza Vaccination (SIV) School Outreach (Free of Charge) Programme - Frequently Used Forms for Medical Practitioners

2023/24 Seasonal Influenza Vaccination (SIV) School Outreach (Free of Charge) Programme - Frequently Used Forms for Medical Practitioners
2023-09-06
Stage Code Document
Before vaccination SIVSO_D_A1(KG)
SIVSO_D_A1(PS&SS)

Booking of Time Slot for Outreach Vaccination Activity
For Kindergarten/Child Care Centre (KG/CCC)
For Primary School & Seconday School


SIVSO_S_A4
SIVSO_S_A4(LAIV)


SIVSO_S_A4_Sec


Seasonal Influenza Vaccination Consent Form (For KG/CCC and Primary School)
- Injectable Vaccine
- Nasal Spray Vaccine

Seasonal Influenza Vaccination Consent Form (For Secondary School)

SIVSO_D_A2 Consent Forms Receipt Note
SIVSO_D_A3
SIVSO_D_A4
Vaccine Ordering (Chinese version only)
- DH Delivery (for 1st and 2nd dose)
- Clinic Delivery (for 2nd dose only)

During vaccination SIVSO_D_B1 Notification to Parents - Seasonal Influenza Vaccination Has Not Been Given
SIVSO_D_B2 Clinical Waste Temporary Storage Handover Note (Chinese version only)
After vaccination SIVSO_D_C1 Vaccine Usage Form (Chinese version only)
DH Delivery (for 1st and 2nd dose)
Self Delivery (for 2nd dose only)
SIVSO_D_C2
SIVSO_D_C2(LAIV)
Information on Side Effects
- Injectable Vaccine
Nasal Spray Vaccine
SIVSO_D_C2(2nd)
SIVSO_D_C2(LAIV)(2nd)
Information on Side Effects and 2nd Dose Arrangement
- Injectable Vaccine
Nasal Spray Vaccine
SIVSO_S_C1 Student Vaccination Report
SIVSO_D_C4 Seasonal Influenza Vaccination Card