Childhood immunisation refusal disclaimer

Use this service to decline vaccinations for your child.

We understand you may have some concerns or questions regarding your child’s immunisations. Therefore, we invite you to please visit the vaccine knowledge website. This website will provide you with evidence based independent information about frequently asked questions and ingredients.

After reading through the website, if you still wish to decline vaccinations for your child, use this service.

You can use this service if you:

  • are registered at the surgery

Before you start

We’ll ask you for:

  • your first and last name, date of birth, sex, postcode, email and phone number
  • if applicable, the details of the person you are completing the form on behalf of

If you have more than one child you are declining immunisations for, fill out a form for each child.

Start now

You can also phone us on 01908 605775.