Form

COVID-19 vaccination: consent form and letter for adults

Coronavirus (COVID-19) vaccination consent form and letter templates for adults who are able to consent.

• From: Public Health England
• Published: 8 December 2020
• Last updated: 9 March 2021 — See all updates

Documents

COVID-19 vaccination consent form for adults who are able to consent (open source version)

ODT, 28.9 KB

This file is in an OpenDocument format

This file may not be suitable for users of assistive technology.

Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

COVID-19 vaccination consent form for adults who are able to consent (MS Word version)

MS Word Document, 30.6 KB

This file may not be suitable for users of assistive technology.

Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

COVID-19 vaccination consent form for adults who are able to consent (PDF version)

Ref: PHE gateway number 2020376

PDF, 51.1 KB, 1 page

This file may not be suitable for users of assistive technology.

Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

COVID-19 vaccination consent form letter for adults who are able to consent (open source version)

ODT, 192 KB

This file is in an OpenDocument format

This file may not be suitable for users of assistive technology.

Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

COVID-19 vaccination consent form letter for adults who are able to consent (MS Word version)

MS Word Document, 205 KB

This file may not be suitable for users of assistive technology.

Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

The coronavirus (COVID-19) vaccination consent form and letter templates are available in different software versions and can be downloaded. The letter templates can be adapted to suit the needs of local healthcare teams.

Copies of the adult consent form (PDF version) are available to order using product code COV2020376V2.

A British Sign Language (BSL) video explaining the COVID-19 vaccination consent form is available to view and download.

Find public health resources

Find this resource on www.gov.uk/publichealthresources where you can view, download or order resources free of charge.

Alternatively, you can get in touch by phone or email.

Please have the product code with you when you contact us.

Email publichealthresources@ukhsa.gov.uk

Contact form https://www.gov.uk/gui...

Telephone: 0300 123 1002

Monday to Friday, 9am to 5:30pm

Published 8 December 2020

Last updated 9 March 2021 + show all updates

1. 9 March 2021

   Added link to BSL consent form video.

2. 21 January 2021

   Updated consent form.

3. 14 December 2020

   Added open source and MS Word version of the adult consent form.

4. 8 December 2020

   First published.