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114th Year Influenza Vaccination Consent Form Electronic Willingness Link Information (Please parents fill out the willingness online before 10/8/114)

{{ $t('FEZ002') }} Student Affairs Office Health Center|

The relevant information for this year's campus trivalent influenza vaccination program is as follows:

Shih Chien Junior High School 114th Year Influenza Vaccination Consent Form Electronic Intent Survey Instructions:

1. Influenza vaccination date: October 29, 114 (Wednesday) 9:00 AM - 12:00 PM.
2. Vaccination unit: Jingmei Hospital.
3. Regardless of whether you intend to be vaccinated, please parents click the link to fill it out.
4. Consent form submission deadline: October 8, 114 (Wednesday) 23:59. (The system will close after the deadline, and failure to fill out the intent will be considered as not vaccinating).

Notes
📌 Please log in with the student's ID number and birthday. Enter English letters in 'uppercase'. Parents please sign their 'full Chinese name' with neat handwriting.
📌 If you wish to change your intention after signing, you can log in to the signing webpage at any time within the deadline of October 8th to change your vaccination intention.
📌 If you leave an email address during online signing, the system will automatically send a confirmation email to that address after the intent is signed.
📌 The brand of vaccine administered on the day will be based on the distribution by the Health Bureau.
The consent form link is as follows:

https://nias-school-survey.cdc.gov.tw/survey/00000000000030B06ad3?openExternalBrowser=1https://nias-school-survey.cdc.gov.tw/survey/00000000000030B06ad3?openExternalBrowser=1

 



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{{ $t('FEZ004') }} 2025-10-28|

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