2021 Flu Vaccination Clinic
Fully covered by all major insurance providers (please bring insurance cards / proof of coverage)

Open to the entire community, ages 12+

Ages 12 - 17 require a parent to be present

High Dose Vaccine will be available for those age 65 and older

Please complete one (1) form per person
First Name *
Last Name *
Date of Birth *
Street *
City *
State *
Zip Code *
Telephone Number *
Email Address *
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