Flu Shot Clinic Survey – Fall 2022

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Flu Shot Clinic Survey – Fall 2022

The Congregational Care team is excited to be partnering again with Walgreens Pharmacy to offer a vaccination clinic. If you would be interested in receiving a vaccination, please fill out the following information. We will provide more details as we get closer to the event. Thanks!

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* Indicates required question

Email *

Your email

Phone Number

Your answer

First Name *

Your answer

Last Name *

Your answer

I would like to receive a vaccination for:

Flu (regular dose)

Flu (High Dose 65+)

Pneumonia

Shingles

Other:

I have the following questions regarding the vaccination clinic:

Your answer

A copy of your responses will be emailed to the address you provided.

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