Get Va Student Tdap Vaccination Consent Form 2020-2025

Filling out the VA Student Tdap Vaccination Consent Form online can be straightforward if you follow the right steps. This guide will walk you through each section of the form to ensure you provide the necessary information accurately and efficiently.

Follow the steps to complete the form successfully.

1. Press the ‘Get Form’ button to acquire the form and view it in a digital format.
2. Begin by entering your child's last name, first name, and middle initial in the designated fields at the top of the form.
3. Select your child's date of birth from the calendar or input it manually using the format MM/DD/YYYY.
4. Indicate your child's age and gender by selecting the appropriate options.
5. If the child is a minor, provide the name of the parent or guardian in the specified field.
6. Fill in the address, grade, and home room teacher's name of your child in the corresponding sections.
7. Provide important contact numbers, including home, cell, and work phone numbers of the parent or guardian.
8. Answer the critical questions about your child's health status, ensuring you check 'YES' or 'NO' for each query to determine eligibility for the Tdap vaccine.
9. Read through the notice regarding HIV and Hepatitis testing before signing the consent form.
10. Complete the insurance section by selecting the appropriate options related to your child's insurance status and providing required details.
11. Review the authorization for disclosure of protected health information and check the box if you wish to receive a copy of the Virginia Department of Health Notice of Privacy Practices.
12. Sign the consent section to authorize your child’s vaccination and provide the date of your signature.
13. If applicable, indicate the mailing address for your child's immunization record.
14. Once you have filled in all the required information, save your changes, and choose to download, print, or share the completed form.

Complete your documents online for a hassle-free experience.