Decline an offer of an Influenza vaccination

If you do not wish to take up the offer of your Influenza vacciation this year, please complete the form below.

Decline Influenza vaccine
I have received an invite from Bellbrooke surgery for an Influenza vaccination and confirm that I do not wish to receive one during the 2020-21 vaccination season. *

Information relating to influenza vaccinations during the 2020-21 season is available on this page