Flu Registration Form
Come prepared with the necessary forms for your flu vaccine:
- DOWNLOAD, fill out, and print out the registration form: Click here.
- DOWNLOAD, fill out, and print out ONE of these screening checklists:
- Flu shot for ages 6 months and over: Click here.
- Intranasal flu vaccine (through the nose) for ages 2-49 years: Click here.
- Bring these forms, a photo ID, and your insurance card to the flu clinic.
- Forms must be printed, signed, and brought to clinic.
- For use in Lorain County Public Health 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.