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It is advised that you have the NHS number of the child that you are completing consent for. Please click the link below to go the the NHS number finder site prior to entering the form. Find NHS Number

The eConsent platform is a web based data system that is used by Midlands Partnership NHS Foundation Trust (MPFT) for the purpose of obtaining electronic consent for childhood immunisations carried out across Staffordshire. To utilise the system you will need to provide personal information that will be held and managed securely.

Please click HERE to access MPFT's Privacy Notice that explains why information is collected about you and the ways in which this information may be used. By entering your details and clicking the continue to consent form button you will be confirming that you have read the Privacy Notice and that you permit the information you disclose via eConsent to be used for the childhood immunisation programme.

If you reject our conditions above, you will be unable to use the eConsent service. Please contact the School Immunisation team by calling 0300 124 0366 or emailing school.immunisation@mpft.nhs.uk to discuss further.

Please enter your email address:

Please select a school:

Please enter the code provided:

Please ensure that you only submit one consent form per child.

eConsent Immunisation Forms

eConsent Immunisation Forms