Flu Shot Interest Form
Please complete this very brief survey to let us know if you would be interested in utilizing TPS as a location for your child's flu shot this winter season. If we receive enough interest, we will schedule a flu shot clinic for December 5. Please complete the first 3 questions of this form, even if you are not interested in using the clinic. If you are interested in the clinic, please then provide information about children and classrooms. This will help us gauge total interest.
Email address *
Your Name *
Your answer
Would you want to utilize TPS as a flu clinic site for your child/ren this winter? *
If yes, please provide the names & classrooms for each TPS child in your family for whom you'd use the clinic:
Your answer
A copy of your responses will be emailed to the address you provided.
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