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.

Documents

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

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)

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)

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)

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)

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.

Health publications orderline

Immunisation Publications Department
Immunisation and Countermeasures
Public Health England
National Infection Service
61 Colindale Avenue
Colindale
London
NW9 5EQ

Contact form https://healthpublicat...

Telephone: 0300 123 1002

Copies of printed publications and the full range of digital resources to support the immunisation programmes can now be ordered and downloaded online. Log in to register and place your order.

Published 8 December 2020
Last updated 9 March 2021 + show all updates
  1. Added link to BSL consent form video.

  2. Updated consent form.

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

  4. First published.