Imms Questionnaire

Dear Parent/Carer

In order to limit the time you need to spend in the surgery during your appointment please read the following questions carefully and let the nurse know if you answer yes to any of the following:

• Is your child unwell today? Do they have a fever, temperature, diarrhoea or sickness?

• Has your child ever had a reaction to a previous vaccination?

• Does your child have a history of fits?

• Does your child have any known allergies eg: eggs (for MMR vaccine)

• Does your child take any medication or are they undergoing any treatment?

• Does your child or any household family member have a low immune system?

Please visit and read the relevant section below according to your child’s age. This contains information about what the vaccines protect against and vaccine side effects.

For information on what to expect after vaccinations please refer to the following patient information leaflet, this also contains information on giving paracetamol for 2 & 4 month vaccinations:

For Rotavirus vaccine info:

If you have any questions please speak to the nurse on the day. 

Many thanks

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