Section Menu

Worksite Flu Shot Request

To request an onsite flu shot clinic for your worksite(s), please submit this form and someone from our office will follow-up with you.

*Asterisk indicates required field.

Requestor Information

Flu Shot Information

Please provide an exact number or an approximate range. If we did a flu shot clinic for you last year and believe the same number of people will attend, indicate that here.

X

Cookie Consent

We use cookies to improve your web experience. By using this site, you agree to our Terms of Use. Read our Internet Privacy Statement to learn what information we collect and how we use it.


Accept All Cookies