Flu Shot Clinic
Name:
Flu Shot Clinic
Date:
October 1, 2021
Time:
10:00 AM - 12:00 PM CDT
Website:
The Chamber
Registration:
Register Now
Event Description:
Below is the Consent form & Vaccination Assessment form; please fill out and bring with you.
Vaccine Administration Record - Informed Consent for Vaccination
(Pre-fill your information with name of doctor you would like to be notified and complete questions 1-6)
Vaccine Administration Record - Informed Consent for Vaccination - Spanish version
Vaccination Assessment
(Pre-fill your information with name of doctor you would like to be notified and complete questions 1-6)
Vaccine Administration Record - Informed Consent for Vaccination - Spanish version
Vaccination Assessment
