Primary childhood immunisation schedule declination

Use this service to decline an immunisation for your child.

If at any time you change your mind and wish the child to receive these vaccinations, please call the surgery to arrange an appointment.

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

Start now

You can also phone us on 01453 842214.