Community Flu Clinic 2020

2020 Flu Clinic Consent- Goodhue Co. Community Flu Clinics

Complete one consent form for each person to be vaccinated. If you need to return to the form to complete it later, click SAVE to receive a link.

Click submit when form is completed. You'll receive a confirmation email.

Click on the link or open the attachment to PRINT THE FORM AND BRING TO THE FLU CLINIC.

If you are unable to bring a printed form, the registrar at the clinic can print it. Homeland Health Specialists will bill your insurance.

Accepted insurances are listed under Payer Information. If you have insurance that is not accepted, you will receive a bill for $35 for a shot, $40 for FluMist, or $65 for High Dose vaccine for age 65 and older. If you do not have insurance,a $20 fee will be requested which can be waived if unable to pay. (Cash only.)

Click below to access the online form:
https://www.cognitoforms.com/HomelandHealthSpecialists1/_2020FluClinicConsentGoodhueCoCommunityFluClinics