Pediatric Vaccination Consent Form
About this free form template

Streamline Pediatric Vaccination Consent with Paperform

Getting parental consent for childhood vaccinations shouldn't involve mountains of paperwork and clipboards. This Pediatric Vaccination Consent Form template helps pediatric clinics, family practices, school health programs, and community health centers gather complete vaccination authorization digitally—saving time, reducing errors, and improving patient safety.

Why healthcare providers trust Paperform for vaccination consent

Built specifically for small and medium healthcare practices, this template captures everything you need before administering vaccines: comprehensive medical history, allergy screening, insurance details, and informed consent—all in one professional, mobile-friendly form. Parents can complete it from home before their appointment, and your staff receives organized, legible information instantly.

The form includes conditional logic that adapts based on responses, ensuring you collect relevant follow-up information without overwhelming parents with unnecessary questions. For example, if a parent indicates their child has allergies, additional fields appear to capture specific details your clinical team needs to know.

Built-in features for busy healthcare workflows

Paperform's calculation engine and conditional logic make this more than a static PDF. You can route submissions to different staff members based on vaccine type, insurance status, or medical flags. Connect the form to your practice management system, send confirmation emails with appointment details, or trigger follow-up reminders for second doses.

Need parents to sign consent digitally? Use Papersign (papersign.com) to turn each submission into a legally binding eSignature document, creating a complete audit trail that links the original form data to the signed authorization—perfect for compliance documentation.

Want to automate what happens next? Stepper (stepper.io) can take each consent form and trigger your vaccination workflow: update your EHR, notify the nursing team, check vaccine inventory, and schedule follow-up appointments—all without manual data entry.

Professional, compliant, and easy to customize

This template follows best practices for pediatric vaccine consent, including space for Vaccine Information Statements (VIS), emergency contact details, and insurance verification. Customize the vaccine list, add your clinic branding, adjust required fields, or translate into multiple languages to serve your community.

With Paperform's SOC 2 Type II compliance and robust security features, you can confidently collect sensitive health information knowing your data is protected. While Paperform is not HIPAA compliant, it provides enterprise-grade security suitable for administrative and consent workflows in healthcare settings.

Whether you run a busy pediatric practice, manage school immunization programs, or coordinate community vaccine clinics, this template helps you gather accurate consent efficiently—so you can focus on keeping children healthy and protected.

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deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
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