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Questionnaire

To be eligible for a Free NHS Flu vaccination one of the following conditions must apply to you

• I'm pregnant

• I live in longstay residential care

• I am a frontline primary care worker

• I'm a carer, social care worker or hospice worker

• I have chronic heart disease (heart failure)

• I have a learning disability

• I have kidney or liver disease

• I have diabetes

• I have asthma or COPD or a long term respiratory condition

• I have had my spleen removed or have an ongoing splenic medical condition

• I have a neurological condition such as Parkinson’s disease, MND or MS

• I have a BMI of 40 or more (severely overweight)

• I have, or someone I live with has, a weakened immune system due to a medical condition (such as HIV), medication or treatment (e.g. cancer chemotherapy)

*You are 50 years old and over (including those who will be 50 years old by 31st March 2023) IMPORTANT: at booking selection, please book from the 15 October onwards

Do any of the above apply to yourself?

Yes No