Notre Dame Church

Flu Shot Sign Up & Consent Form

NOTRE DAME PARISH

DRIVE-THRU FLU SHOT PROGRAM

Saturday, September 26^th

9:30am – 12:30pm

No need to get out of your car! Ages 3 and above. Senior high-dose flu shot available. Covered by Medicare, Medicaid and most private health insurance. Bring your insurance card.

WE HAVE REACHED OUR SIGN-UP LIMIT. REGISTRATION IS NOW CLOSED.

1) To select a time to get your flu shot, sign up using this form: Sign-Up Form

2) See link below for Consent Form document. Be sure to print out and bring your completed form along with your insurance card.

Attached Files

Consent Form for Immunization 2020.pdf

Flu Shot Sign Up & Consent Form

*WE HAVE REACHED OUR SIGN-UP LIMIT. REGISTRATION IS NOW CLOSED.*

1) To select a time to get your flu shot, sign up using this form: Sign-Up Form

2) See link below for Consent Form document. Be sure to print out and bring your completed form along with your insurance card.

Attached Files

WE HAVE REACHED OUR SIGN-UP LIMIT. REGISTRATION IS NOW CLOSED.