Form

Human papillomavirus (HPV) vaccination consent form

The HPV universal vaccination consent form for schools to distribute to parents of pupils.

• From: UK Health Security Agency
• Published: 30 September 2012
• Last updated: 28 June 2023 — See all updates

Applies to England

Documents

Human papillomavirus (HPV) vaccination consent form: effective from September 2021 (Word version)

MS Word Document, 45.3 KB

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Human papillomavirus (HPV) vaccination consent form: effective from September 2021 (PDF version)

Ref: PHE gateway number 2021218

PDF, 115 KB, 1 page

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Human papillomavirus (HPV) vaccination consent form: effective from September 2023 (Word version)

Ref: 2022676

MS Word Document, 38.4 KB

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 [email protected]. Please tell us what format you need. It will help us if you say what assistive technology you use.

Human papillomavirus (HPV) vaccination consent form: effective from September 2023 (PDF version)

Ref: 2022676

PDF, 96.8 KB, 1 page

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 [email protected]. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

Guidance from September 2021

The HPV vaccine, that protects against cervical cancer, is being offered to your daughter or son at school. The leaflet that accompanies this form tells you and your child about the HPV vaccine.

To get the best protection, it is important that they receive both of the 2 injections. Please discuss this with your child, then complete this form and return it to the school before the vaccination is due to be given.

Schools can download the form in a choice of formats to send to parents for them to consent to their child’s vaccinations.

A British Sign Language (BSL) video of this HPV consent form) is available to watch on YouTube.

This BSL video is available to download.

Guidance from September 2023

From September 2023, there will be changes to the dose schedule in the HPV vaccination programme. The current and updated versions of these resources are available for your information.

Published 30 September 2012
Last updated 28 June 2023 + show all updates

1. 28 June 2023

   Added consent forms effective from September 2023.

2. 9 November 2021

   Added British Sign Language video of HPV consent form.

3. 28 October 2021

   Added link to British Sign Language video of consent form.

4. 28 July 2021

   Added updated consent forms.

5. 27 June 2019

   Added the HPV universal vaccination consent form.

6. 10 June 2014

   Updated with the new consent form effective from September 2014.

7. 30 September 2012

   First published.