On-Site Event Request

On-Site Flu Shot Request

  • Preferred On-Site Date & Start Time

    Flu shots are available for participants 18 yrs. of age and older

  • (mm/dd/yyyy)
  • (mm/dd/yyyy)
  • (mm/dd/yyyy)
  • Eligible Participants (check all that apply):
  • If you are requesting service for multiple offices/times, please complete a reservation request for each.

  • A labor fee of $150/hour/nurse will be applied during non-standard business hours and for flu-only events that average less than 20 shots per hour.

    Travel fees may also apply for events outside a 30 mile radius of 63127.

  • Payment:

    All charges will be Master Billed to the Company, and are due within 30 days of receipt (no insurance billing).