JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Mosaic Flu Shot Drawing
Get your flu shot and enter for your chance to win a PRIZE!
* Indicates required question
Email
*
Your email
Did you receive a flu shot in September, October or November of 2020?
*
Yes
No
Submit
Clear form
This form was created inside of Mosaic.
Report Abuse
Forms
