The main reasons that a referral doesn't appear on the clinic sheet are:

1. The consent has been received after the clinic has been generated.
   Please ensure all consents are triaged before downloading your clinic on the iPad or downloading the clinic spreadsheet.
2. The consent has no vaccination records. This usually occurs because parents have completed more than one consent, which is a duplicate consent. The vaccination records will be on the first consent received. The consent may be for the same child but in two different schools.
3. The consent is still in conflicting consent triage status – parents have submitted two consents, one consent given, and one consent not given.
4. The consent has been clinically declined or declined out of the cohort.

To resolve a conflicting consent, please follow the next set of instructions:

Step 1: Find the consent in the school's list.

This should be in the Immunisation programme, e.g., "Flu—Conflicting consents" in the current step. There should be an orange labeled Duplicate next to the child's name. If several children have conflicting consents in the school, you can search for them by typing "conflicting" into the search bar, and a list should appear.

Step 2: Select the Primary record for the child

This will open the child's patient record. You will see that the Consent status on the vaccination record is ‘Conflicting consents’, and an immunisation event will be listed in the timeline stating that a previous consent with a reference number has been received.

Step 3: Triage the consent

You will be able to see from the associated consent forms that one consent says yes, and the other consent says no. The team will need to contact the parent for further instruction. The team will then decide to vaccinate the child at the clinic or decline the consent as instructed by the parent.

Step 4: Update the consent status

If you receive authorisation to vaccinate the child:

If the parent agrees to have their child vaccinated, choose the 'yes' consent. If the 'yes' consent is the duplicate, you will need to change this consent to the primary consent to see a vaccination record against this consent.

To change a duplicate consent to the primary, select the Immunisations tab on the left and select primary consent in actions. This will make the consent given the primary consent:

Select the Immunisations tab on the left-hand navigation menu, then select the action arrow. From the drop-down menu, select Update consent status.

A pop-up window will appear. Choose the consent status, given or not given, then select the triage step to move this to. For example, Flu Ready or parent declined. If the consent status has been updated to yes and the consent moved to the Flu Ready step, the child will appear on the clinic list. The primary consent will now become a duplicate and will not have a vaccination record against it.