September 28, 2009
Dear Parents,
The Fairfield County Health Department will offer Flu Vaccines to RWA students again this year on Wednesday October 7, 2009. Students under 18 are eligible to receive the vaccine free of charge. Enclosed is a copy of the Permission slip for your child and a Vaccination Administration Record (3518). Also there is a Clients Bill Of Rights and a Vaccine Information Sheet (VIS) for you to review and keep as a personal copy. Please complete the Permission Slip in its entirety. The Vaccination Administration Record (3518) needs the following two parts completed: Alternate Method of Contact (top of page Parent/ Legal Guardian signature (mid page). The remaining information can be completed by us from the Permission slip for the 3518. Please return the two signed forms to school before Friday October 2nd. You can keep the Clients Bill of Rights and the Vaccine Information Sheet for your own information.
Thank you for the opportunity to vaccinate your child.