Flu Shot Form

    FIGHT THE FLU
    DO YOU GET YOUR CHILD IMMUNIZED FOR THE FLU?
    THE FLU SHOT IS HIGHLY RECOMMENDED BY THE CDC AND AMERICAN ACADEMY OF PEDIATRICS. THE DEPARTMENT OF HUMAN SERVICES WHICH REGULATES CHILD CARE FACILITIES ARE NOW REQUIRING THE FLU SHOT TO BE ADMINISTERED TO CHILDREN ABOVE THE AGE OF 6 MONTHS.
    IF YOU DO NOT WANT YOUR CHILD TO RECEIVE THE FLU SHOT, PLEASE FILL OUT THE FORM BELOW.



    DO NOT WANT MY CHILD TO RECEIVE THE INFLUENZA IMMUNIZATION.