This consent form is for students who would like to have one or more of the following vaccines (Tdap/MCV/MCVB/HPV) administered during the HNH Vaccine Clinic at East Samford School on May 7, 2024. This is for students who have insurance other than PEEHIP. Vaccines cannot be administered to students with PEEHIP insurance. Deadline to submit consent forms is May 3, 2024.

The Alabama State Department of Education and Alabama Department of Public Health require school districts in Alabama to offer and provide scoliosis screening for male and female students in grades 5-9.

This is an opt-in program. Please print and complete the consent form. Submit the form to Nurse McClary indicating your wishes for scoliosis screening.

Please note: If a signed consent form is not received by March 25, 2024 your student will not be screened.