eConsent Immunisation Forms
eConsent Immunisation Forms
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.
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 email@example.com to discuss further.
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Please select a school:
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The De Ferrers Academy - 25 Jun 2021 HPV
Discovery Academy - 25 Jun 2021 HPV
Endon High School - 23 Jun 2021 HPV
Erasmus Darwin Academy - 24 Jun 2021 HPV
Sir Thomas Boughey Academy - 24 Jun 2021 HPV
Wombourne High (formally Ounsdale) - 28 Jun 2021 HPV
St Dominic's Priory School - 29 Jun 2021 HPV, MenACWY
Madeley High School - 22 Jun 2021 MenACWY
The Weston Road Academy - 22 Jun 2021 HPV
The Meadows School - 22 Jun 2021 HPV, MenACWY
St Margaret Ward Catholic Academy - 30 Jun 2021 HPV
St Thomas More Catholic Academy - 29 Jun 2021 MenACWY
Tamworth Enterprise College And AET Academy - 23 Jun 2021 HPV, MenACWY
Bailey Street Academy - 23 Jun 2021 HPV, MenACWY
Kettlebrook Pupil Referral Unit - 24 Jun 2021 HPV, MenACWY
Merit Pupil Referral Service - 24 Jun 2021 HPV, MenACWY
Kinetic Academy - 24 Jun 2021 HPV, MenACWY
Newcastle Academy - 28 Jun 2021 MenACWY
Cedars - Newcastle - 28 Jun 2021 HPV, MenACWY
Excellence Girls Academy - 28 Jun 2021 HPV, MenACWY
Alleyne's Academy - 29 Jun 2021 HPV, MenACWY
Wightwick Hall - 29 Jun 2021 HPV, MenACWY
Longdon Hall School - 30 Jun 2021 HPV, MenACWY
Rugeley School - 30 Jun 2021 HPV, MenACWY
Chase Grammar School - 25 Jun 2021 HPV, MenACWY
Cheslyn Hay Sport And Community High School - 01 Jul 2021 MenACWY
The Rawlett School (An Aet Academy) - 01 Jul 2021 HPV
Norton Canes High School - 05 Jul 2021 HPV
The Friary School - 05 Jul 2021 MenACWY
Landau Forte Academy - Amington - 02 Jul 2021 HPV, MenACWY
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Please ensure that you only submit one consent form per child.