On-site COVID-19 Testing Clinic

On-Site Flu & COVID-19 Vaccine Clinic Inquiry

Once we receive the filled form, we will contact you shortly to confirm availability.
For on-site flu and COVID-19 vaccine clinics, there is a minimum requirement of 10 vaccinations (including flu and COVID) per clinic.

Most insurances cover the cost of the flu vaccine completely with $0 copay. Kaiser patients will have a small cash price of $25.
Business Name *
Point of Contact Full Name *

First Name Last Name
E-mail *
example@example.com
Phone Number *
Business Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Estimated Number of Individuals Needing Vaccinations *
Preferred Day of Week - 1st Choice *
Preferred Day of Week - 2nd Choice *
Preferred Time of Day *
Are you interested in on-site COVID-19 vaccinations? *
Which COVID-19 vaccines are you interested in?

Moderna Pfizer J&J
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On-Site Flu & COVID-19 Vaccine Clinic Inquiry