Flu Registration Form

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

Print this form and fill it out on the day you plan to get your flu shot. Bring it with you to the flu clinic.


  • Forms 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.