Thank you for choosing Irwin County Health Department to provide your child’s influenza vaccination.

Irwin County Health Department will be offering printed consent forms this year. Consent forms will be distributed by your child’s school or can be picked up at the health department.

If you need assistance completing your forms, please stop by the health department and our staff will be happy to assist you.

All forms must be completed and returned to the school or health department by August 29, 2025.

Linked below are the School Based Flu Consent form for Irwin County, as well as South Health District’s HIPAA Privacy Notice (available in English and Spanish) and the Center’s for Disease Control and Prevention’s Influenza Vaccination Statement.

Parent Letter English
[PDF, 523.93 KB]Parent Letter Spanish (Carta a las padres)
[PDF, 128.69 KB]Consent Form English
[PDF, 256.64 KB]Consent Form Spanish (Formulario de consentimiento)
[PDF, 247.55 KB]HIPAA Privacy Notice (English and Spanish)
CDC Vaccine Statement [PDF]