Dear PHC Families,
We are passionate about keeping your children protected from influenza and we believe the drive-thru/curbside model is the safest and most effective way to vaccinate our established patients this year.
Please keep in mind that WEATHER MAY IMPACT THESE CLINIC DATES.
To keep things running smoothly and efficiently, we need your help and cooperation.
- Please read each section carefully AND fill out all required fields.
- Please watch the short video below in its entirety to prepare for your visit.
- THE FORMS BELOW MUST BE COMPLETED, PRINTED, AND BROUGHT WITH YOU ON THE DAY OF THE CLINIC.
- Please ensure that our office has your insurance information on file as we are unable to take your cards on the day of the clinic.
- Please complete your appointment scheduling at the end of this form.
- ***If you are scheduling more than 3 children, please contact our office at (586) 254-7593 to schedule instead.***
Thank you for your cooperation!