Flu Decline

If you have been contacted by the Practice or are eligible to receive a free flu vaccination for this year’s flu campaign (eligibility below) and wish to decline please complete the following information.

If you change your mind during the flu campaign, you can still have the vaccine and can arrange this by contacting the Practice.
Full Name
Date of Birth

People who should have a flu vaccination

The injected flu vaccine is offered free of charge on the NHS to people who are at risk; this is to ensure they are protected against catching flu and developing serious complications.

You are eligible to receive a free flu jab if you:
  • are 65 years of age or over (if you are currently 64 but will be 65 on March 31 2020, you do qualify)
  • are pregnant
  • are living in a long-stay residential care home or other long-stay care facility
  • receive a carer’s allowance, or you are the main carer for an elderly or disabled person whose welfare may be at risk if you fall ill

Have certain medical conditions:

Front-line health and social care workers are also eligible to receive the flu vaccine; it is your employer’s responsibility to arrange and pay for this vaccine.