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IT'S ANNUAL FLU SHOT TIME!

October 15, 2018

Please find attached the flu vaccination forms: 

1) flu vaccine consent form

2) influenza vaccine information statement

3) NCCHS privacy policy

4) information on filling out the consent form and including payment or a copy of the health insurance card (cover letter). 

All forms need signed/copy of insurance and or payment at time of shot. Forms need returned no later than Monday 10/22.

All students need to have their own copy of insurance. i.e.- one copy for a family of 2 or more kids won't work. Each needs their own copy attached to their forms.

Staff - please make sure you have your insurance card ALREADY COPIED and hand it in with the forms filled out. 

Persons receiving a flu shot need all four of these:

COVER LETTER

CONSENT FORM

PRIVACY POLICY

VACCINE INFORMATION STATEMENT

 

 

 

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