10/16 Seasonal Influenza Vaccine Information & Consent Form




Dear Parents/Guardians:

The Hsinchu American School is working with the local health bureau to give seasonal influenza vaccination to your child at the school on November 5, 2020. This document is intended to inform you of the upcoming vaccination campaign and ask for your signed consent. All students are required to fill out the consent form. After reading the following information, please fill out the vaccination consent form and return it to Ms. Kelly (Room 301) before Tuesday, October 20th. Thank you for your cooperation and support.


Sincerely,

Hsinchu American School Admin Office



親愛的家長您好:


本校為配合本縣(市)衛生局合約醫療團隊於2020年11月5日為您的子女進行流感疫苗接種服務,特此通知並徵求您的同意,請您閱讀下列資訊後,無論是否接種,請將意願書於10月20日前交還給Ms. Kelly。

感謝您的支持與配合!


敬祝



安康新竹美國學校行政辦公室



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109年季流同意書-雙語版 - Google 文件
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