¶¶Òõ¶ÌÊÓÆµ

Immunization Release Form Template for England and Wales

Create a bespoke document in minutes,  or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Immunization Release Form

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Immunization Release Form

"I need an Immunization Release Form for my private medical practice in Cardiff that covers COVID-19 booster shots and seasonal flu vaccines, with specific provisions for elderly patients and those with autoimmune conditions."

Document background
The Immunization Release Form is designed for use in medical settings throughout England and Wales where vaccinations are administered. This document is essential for ensuring informed consent and maintaining accurate medical records. It includes patient information, medical history, specific vaccine details, and risk acknowledgments. The form meets requirements set by the NHS, UK GDPR, and relevant healthcare regulations, providing legal protection for healthcare providers while ensuring patient safety and informed decision-making. It is particularly crucial in situations involving routine vaccinations, travel immunizations, or workplace vaccination programs.
Suggested Sections

1. Personal Information: Section for patient's full name, date of birth, NHS number, and contact details

2. Medical History: Questions regarding relevant medical history, allergies, and contraindications

3. Vaccine Details: Information about the specific vaccine(s) to be administered, including type and batch numbers

4. Risk Disclosure: Detailed statement of potential risks and side effects associated with the vaccination

5. Consent Declaration: Formal statement of informed consent for vaccine administration

6. Healthcare Provider Information: Details of the administering healthcare provider and facility

7. Signature Block: Space for patient/guardian signature, date, and witness signature if required

Optional Sections

1. Emergency Contact Information: Section for secondary contact details, recommended for high-risk patients or facility requirements

2. Previous Vaccination History: Record of past immunizations, particularly relevant for booster shots or vaccination series

3. Insurance Information: Section for private medical insurance details, applicable for private healthcare facilities

4. Interpreter Declaration: Additional section when information has been translated for non-English speaking patients

5. Guardian Authorization: Additional section required when the patient is a minor or lacks capacity to consent

Suggested Schedules

1. Vaccine Information Sheet: Detailed technical information about the specific vaccine(s) being administered

2. Side Effects Guide: Comprehensive list of common side effects and guidance on when to seek medical attention

3. Post-Vaccination Care Instructions: Detailed guidelines for patient care and monitoring after receiving the vaccine

4. Emergency Contact Numbers: List of relevant emergency contact numbers and healthcare facilities

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓÆµ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions

























Clauses




















Relevant Industries
Relevant Teams
Relevant Roles
Industries

Public Health (Control of Disease) Act 1984: Primary legislation governing public health measures and disease control in England and Wales

Health and Social Care Act 2012: Fundamental legislation establishing the structure and responsibilities of the NHS and public health system

National Health Service Act 2006: Core legislation governing the operation of the National Health Service in England and Wales

Medicine Act 1968: Legislation controlling the manufacture and supply of medicines in the UK

Data Protection Act 2018: UK implementation of GDPR, governing personal data processing and protection

Health Protection (Vaccination) Regulations 2009: Specific regulations governing vaccination procedures and requirements

Human Medicines Regulations 2012: Detailed regulations controlling the supply, manufacture, and administration of medicines

NHS Pharmaceutical Regulations 2013: Regulations governing pharmaceutical services within the NHS

Mental Capacity Act 2005: Legislation governing decision-making and consent for those who may lack capacity

Family Law Reform Act 1969: Legislation covering consent requirements for medical treatment of minors

Children Act 1989: Key legislation protecting children's welfare and rights in medical contexts

GMC Guidance: Professional standards and guidelines from the General Medical Council

NMC Standards: Professional standards from the Nursing and Midwifery Council

Public Health England Guidelines: Official guidance on public health practices including immunization

Caldicott Principles: Guidelines for handling patient-identifiable information in healthcare

NHS Information Governance: Framework for handling NHS information and maintaining confidentiality

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Vehicle Release Form Towing

find out more

Vehicle Release Authorisation Form

find out more

Vehicle Property Release Form

find out more

Transcript Release Authorisation

find out more

Temporary Medical Permission Form

find out more

Temporary Guardian Medical Release Form

find out more

Simple Release Form

find out more

Simple Medical Release Form

find out more

Simple Medical Consent Form

find out more

Return To Work Medical Release

find out more

Release Of Medical Records To Family Members Form

find out more

Release Of Information Form For Rental History

find out more

Release Of Care Form

find out more

Release Letter Form

find out more

Protected Health Information Form

find out more

Probate Receipt And Release Form

find out more

Printable Medical Records Release Authorisation Form

find out more

Printable Media Release Form

find out more

Printable Dental Release Form

find out more

Physical Therapy Release Form

find out more

Photo Printing Rights Release Form

find out more

Permission To Use Photo Agreement

find out more

Paid In Full Release Form

find out more

Package Release Form

find out more

Military Medical Records Request Form

find out more

Mental Health Records Release Form

find out more

Medical Treatment Authorisation Form

find out more

Medical Treatment Authorisation And Consent

find out more

Medical Release Form To Return To Work

find out more

Medical Release Form For Family Members

find out more

Medical Release Consent Form

find out more

Medical Consent Authorisation Form

find out more

Licence Release Form

find out more

Legal Release Form

find out more

Letter Of Consent Medical Authorisation Form

find out more

Impound Release Form

find out more

Hospital Release Form

find out more

Hitech Release Form

find out more

Generic Printable Medical Records Release Authorisation Form

find out more

General Release Of Information Consent Form

find out more

General Medical Record Release Form

find out more

General Authorisation To Release Information Form

find out more

Employment Verification Release

find out more

Employer Release Of Information Form

find out more

Emergency Medical Treatment Authorisation Form

find out more

Emergency Medical Authorisation Form

find out more

Driving Record Consent Form

find out more

Dental Release Form

find out more

Dental Records Request Form

find out more

Dental Photo Consent Form

find out more

Dental Patient Release Form

find out more

Dental Medical Records Release Form

find out more

Daycare Medical Release Form

find out more

Consent To Release Personal Information Form

find out more

Consent To Release Medical Records

find out more

Consent For Release Of Protected Health Information

find out more

Client Authorisation To Release Information To Third Parties

find out more

Car Title Lien Release Letter

find out more

Basic Photography Release Form

find out more

Background Release Form

find out more

Authorisation To Use And Disclose Protected Health Information Form

find out more

Authorisation To Release Records

find out more

Authorisation To Release Personal Information

find out more

Authorisation To Release Loan Information

find out more

Authorisation To Release Legal File

find out more

Authorisation To Release Information To Family Members

find out more

Authorisation To Release Information To A Third Party Form

find out more

Authorisation To Release Information

find out more

Authorisation To Release Immunization Records

find out more

Authorisation To Release Health Care Information

find out more

Authorisation To Release Credit Information Form

find out more

Authorisation To Disclose Information

find out more

Authorisation Letter For Release Of Information

find out more

Authorisation For Disclosure Of Information Form

find out more

Authorisation For Disclosure

find out more

Authorisation Disclosure Form

find out more

Authorisation For Release Of Protected Health Information Phi

find out more

Authorisation For Release Of Personal Information

find out more

Authorisation For Release Of Information Form

find out more

Authorisation For Release Of Health Records

find out more

Authorisation For Release Of Health Information

find out more

Authorisation For Release Of Financial Information

find out more

Authorisation For Release Of Employment Records

find out more

Authorisation For Release Of Employment Information

find out more

Authorisation For Release Of Dental Records

find out more

Authorisation For Release Of Confidential Information

find out more

Authorisation For Release Of Cell Phone Records

find out more

Authorisation For Disclosure Of Protected Health Information Form

find out more

Authorisation For Disclosure Of Medical Information

find out more

Actor Release Form

find out more

Authorisation Of Release Of Unemployment Records Form

A legal form used in England and Wales to authorize the release of individual unemployment records in compliance with UK data protection laws.

find out more

Authorisation For Release Of Records

A legal document under English and Welsh law authorizing the release of specific records from one party to another, in compliance with UK data protection legislation.

find out more

Release Of Information Statement

A legal document under English and Welsh law authorizing and governing the release of specific information between parties while ensuring data protection compliance.

find out more

Printable Work Release Form

A legally binding document under English and Welsh law that formalizes the termination of employment and mutual release of claims between employer and employee.

find out more

Dental Release Of Information Form

A legal document under English and Welsh law authorizing the release of dental records and information to specified parties.

find out more

Work Release Form From Doctor

A medical document used in England and Wales certifying an employee's fitness to return to work, compliant with UK healthcare and employment regulations.

find out more

Universal Medical Release Form

A legal document under English and Welsh law authorizing the release of medical records to specified parties while ensuring data protection compliance.

find out more

Service Release Form

A legally binding document under English and Welsh law that releases parties from obligations and liabilities related to completed services.

find out more

Revocation Of Release Of Information Form

An English and Welsh law-compliant document for withdrawing previously granted authorization for information sharing and processing.

find out more

Release Form For Video Recording

A legal document under English and Welsh law that obtains consent for video recording and establishes usage rights for the recorded content.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: /our-research
Oops! Something went wrong while submitting the form.

³Ò±ð²Ô¾±±ð’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; ³Ò±ð²Ô¾±±ð’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a £1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our for more details and real-time security updates.