14 Maple Street
P.O. Box 841
Belchertown MA 01007


Home 5 Student Flu Clinic Parent Information Sheet

***We have a limited supply of flu vaccine for students.  Contact your school nurse for details.***


Please note that a parent or guardian must accompany their child.  Please print and fill out the Parent Permission Form and read the VIS – Vaccine Information Statement prior to the flu clinic.  The two forms can be found by clicking on the preceding links or using the links in the bulleted list below. Please also have your child wear a short sleeve shirt for convenience.

Please also download and complete the 2016 Flu Insurance Form. PLEASE BRING YOUR INSURANCE CARD. We will have a copier available at the immunization clinic for your convenience to make a copy of your insurance card. The flu vaccine will be FREE of charge and there will be NO co-pay. Please call Phyllis DuComb at 323-0471, ext. 28 if you have any questions about this form.



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