Injectable Flu Vaccine Clinic & Consent Form

Wed, 09/13/2017 - 3:07pm

Influenza, also known as the flu, is a serious illness that affects people of all ages.  One of the best ways to prevent the flu is through vaccinations.  We are pleased to again join with the Maryland Partnership for Prevention (MPP) to offer flu vaccinations at our school.

New this year, you may give permission for your child to be vaccinated using (1) an online form at  or (2) the hard copy form (click here to download).

We urge you to protect your family from the flu. The Centers for Disease Control and Prevention (CDC) recommends that everyone ages 6 months and older get a flu shot. Please visit for more information about the flu vaccine.

The clinic at Marriotts Ridge HS will be held on October 4, 2017.  We will send a notice home the day your child has been vaccinated. 

If you want your child to be vaccinated, please:

  1. Fill out every section of the attached consent form OR complete it online at by September 22, 2017.  If you fill out the paper consent, write neatly and use ink.  Only fill out the hard copy consent OR the online consent.  Do NOT fill out both.
  2. Use your insurance card to fill out your insurance information accurately.  Your insurance company will be billed.  There is no co-pay or deductible.  You will NOT be charged by us or your insurance company. 
  3. Read the Vaccine Information Statement (VIS) and talk to your health care provider or the school nurse about any questions you have.
  4. Return paper copy or complete the online consent form no later than September 22, 2017.

To complete the consent form online, go to: