Flu Registration Form

Please click on the form, fill it out completely, print it, and bring it with you to the flu clinic. 

 


Injectable Vaccine

This vaccine is s traditional shot with a needle, usually into the arm, and is recommended for all ages 6 months and older. Complete and print the form below if you want to receive this vaccine.

 

Injectable Vaccine Form 

 


  • Form must be printed, signed, and brought to clinic.
  • For use in Lorain County General Health District Clinics only.
  • One form per person is required for vaccine.
  • If you are under 18 then you must be accompanied by a parent or guardian.

 

Flu RSS Aggregator

Flu RSS Aggregator Widget. Flash Player 9 is required.
Flu RSS Aggregator Widget.
Flash Player 9 is required.