Schedule a Flu Clinic Help your employees stay healthy and productive Step 1 of 3 33% Company or Organization* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Contact InformationContact Person* First Last Phone*Email* Alternate Contact Person First Last PhoneEmail Your Preferences regarding your Flu Clinic(s)If you do not have a strong preference we will contact you with some options. If you want a specific date and time for a clinic please complete the comment section at the end of this form.Would You prefer to have* One Clinic at one location Clincs at different locations Several Clinics at one location Preferred month*JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberPreferred time of day* Morning Around noon Afternoon Must be a specific time Time : Hours Minutes AM PM AM/PM Payment will consist of* Participants paid Company paid Insurance and company paid Insurance and participant paid Not sure yet Approximate number of participants*Additional informationPhoneThis field is for validation purposes and should be left unchanged. Δ Questions about scheduling a flu clinic? We're happy to help Get in touch
