WBSD/BMC/OCHD Vaccination Clinic Interest Form
The West Bloomfield School District is partnering with the BMC Pharmacy (located in the Beaumont Medical Center) and the Oakland County Health Division to offer vaccination clinic opportunities at West Bloomfield High School for students (age 12 and above) and families during the month August. In order to help facilitate an organized and safe clinic experience, we are asking families to fill out the Google Form below to express interest in the clinic and provide necessary contact information related to the event.

Those receiving vaccinations under the age of 18 must have a parent or legal guardian present at the clinic.

Filling out the form below does not commit you to an appointment in the event of a scheduling conflict, the form simply helps BMC and OCHD prepare for an organized and safe clinic.
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Name:
Phone Number:
Email:
Names and ages of student(s) participating in clinic:
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