The Stillwater Billings Clinic will be providing Flu Shots at the Park City Schools on MONDAY, OCTOBER 23, AT 11:30 am
If you would like your child to receive vaccination at the school, the following must be completed to receive a vaccine:
1. Fill out the enclosed Consent Form
2. If you have insurance (including Medicaid) and would like it to be billed, please make a copy of your insurance card (front and back) and attach to consent form
3. If you are paying cash - $30 is needed in either cash or check along with the consent form.
ADULT CONSENT FORM
CHILD CONSENT FORM