Vaccine Decline
Should you wish to receive only 1 jab (either Flu or Covid-19 booster), please advise the clinician when you attend your appointment and we will be more than happy to support you.

However, in order to update your medical records beforehand, please complete the following.

In line with NHS England direction, you must decline the vaccines every season.
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Full name *
Date of birth *
MM
/
DD
/
YYYY
Decline from flu vaccination? *
Decline from Covid-19 booster? *
Submit
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