Subject: – COVID – 19 Vaccination of Students of Class (VIII-X) – Parental Consent.

Oct 13, 2021 | MATRIC CAMPUS

  1. It is to inform our worthy parents that Government of Sindh has announced and notified for the vaccination of COVID-19 for students who are 15 years of age and above to ensure more safety against of COVID pandemic.

 

 

  1. As per the notification issued this vaccination is mandatory for above mentioned students, however, parental consent is to be sought before its formal procedure/administration of vaccination.

 

  1. Kindly fill in the given consent slip with necessary particulars and return it to respective class teacher latest by Thursday, 7th Oct, 2021. The special teams of medical experts formed by DHO will visit the school to vaccinate our students. The date of vaccination will be informed to parents and students well in advance.

 

  1. Submitted for your kind information please.

 

 

With Kind Regards,

BASS Management

 

 

COVID-19 Vaccine Registration and Consent Form
CNIC # as per B form
Dated
Name of Student
Age Gender Male/Female
Grade/Class
Father’s Name
Father’s CNIC # – –
Contact #
Address
Town/Taluka District
School
Sector Public Private
Address  

 
 

H/of COVID-19 Infection

 Yes No Don’t Know
If Yes please provide details Date OR Month of Diagnosis
History Hospitalization Yes No

 

Consent Form: I give consent to the Health Department and its authorized staff for my child named written above to receive the COVID-19 vaccine __________________________. I believe the benefits outweigh the risks, and I accept full responsibility for any reactions that may result from the receipt of the immunization.

If my child experience any adverse reactions after leaving, I will notify them at the designated person at number.

I hereby declare that all the given information is accurate.

 

 

 

 

 
School Headmaster Parents/Guardian Signature