Flu Consent Form Online

Dear Parent/Guardian:

The flu vaccine is the best way to prevent the flu.  It is especially important that children with certain health problems like asthma, diabetes or weakened immune systems get vaccinated every year.

The South Carolina Department of Health and Environmental Control (DHEC) is working with your school district to provide flu vaccine at your child’s school this fall. The flu shot will be the only flu vaccine given in school clinics this year. 

Flu shots are affordable at school clinics.  If your child has:

  • Medicaid: Medicaid will be billed for $13.
  • No health insurance: You will receive a bill from DHEC for $13.
  • Private health insurance: DHEC will file a claim for $13 with your insurance carrier. Any balance remaining may be billed to you.

If you would like your child to get a flu shot at school:

  1. Go to and enter 11001002 as your validation code.
  2. Complete the online consent and submit to DHEC.

If your child is under the age of 9, he or she may be recommended to get a second flu shot for the best protection. You will be notified if your child will need a second flu shot.

If your child does not receive the flu vaccine at school, please consider contacting your child’s healthcare provider or health department about getting the flu shot. The important thing is to protect your child from the flu by vaccinating them.


Teresa A. Foo, MD, MPH

Medical Consultant, Immunization Division         


The deadline to complete the form is November 10.