The Hampshire County Health Department has been developing plans for the possibility of a Pandemic Influenza Event.  We have been working closely with Eastern Panhandle Health Response Team, Hampshire County Office of Emergency Management (OEM), Law Enforcement, Emergency Medical Services (EMS), and Local Emergency Planning Committee (LEPC).  We are committed to the health and safety of our community.

The Forms are in  PDF format and require that your computer be running Adobe® Reader software.  Please Note: If you experience difficulty in downloading or printing forms, please refer to the Adobe Web Site for troubleshooting and support guidelines.

H1N1 Vaccination Consent Forms

H1N1 Inactivated VIS FINAL 10-02-09

H1N1 LAIV VIS FINAL 10-02-09

Combination Consent Form 09-02-09 v1 2

The following links are provided as resources H1N1 Information:

www.wvflu.org