Jai Medical Centre

Edgware Surgery, 114 Edgwarebury Lane, Edgware, HA8 8NB

Telephone: 0300 033 7861

We're open

Hendon Surgery, 42 Station Road, Hendon, NW4 3SU | Telephone: 0300 033 7860

Flu Vaccination Consent Form

I, the undersigned have read the information below and hereby give consent to have the flu vaccine, I also confirm that the following apply:

  • I am NOT allergic to egg or chicken protein
  • I am NOT allergic to antibiotics (neomycin or polymycin)
  • I am NOT allergic to mercury compound (thiormersal)
  • I do NOT have a fever or think that I may be getting a fever
  • I have NOT had a serious reaction to any flu vaccine in the past

For more information on flu-influenza vaccine please click on the link

or you may also complete online consent form

Flu Vaccination Consent

  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

 

Edgware Surgery

  • Monday
    08:00am to 06:30pm
  • Tuesday
    08:00am to 06:30pm
  • Wednesday
    08:00am to 06:30pm
  • Thursday
    08:00am to 06:30pm
  • Friday
    08:00am to 06:30pm
  • Saturday
    CLOSED
  • Sunday
    CLOSED

Hendon Surgery

  • Monday
    09:00am to 06:30pm
  • Tuesday
    09:00am to 06:30pm
  • Wednesday
    09:00am to 06:30pm
  • Thursday
    09:00am to 06:30pm
  • Friday
    09:00am to 06:30pm
  • Saturday
    CLOSED
  • Sunday
    CLOSED
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