Worksite Flu Shot Request

Thank you for your interest in requesting flu shots from Henry Ford Health System (HFHS). The flu vaccine is a covered medical benefit for HAP HMO, Alliance Health and Life (AHL) members, BCN and Medicare. We will arrange for payment for non-HAP, BCN and Medicare participants with you upon scheduling your flu shot clinic.

Please submit your request as far ahead of time as possible.

* Asterisk indicates required field.

Today's Date
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Flu Shot Information
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Number of People Expected











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