Good morning/afternoon:
The Bangor Public Health staff will be offering flu shots to students and staff at CENTER DRIVE SCHOOL on:
Tuesday, October 27 th , from 11:00 AM – 1:00 PM
Monday, November 2 nd , from 11:00 AM – 1:00 PM
For STUDENTS, the flu vaccine will be provided at no charge to all students. We ask that parents/legal guardians legibly complete the insurance information, as the Bangor Public Health Department is able to bill a small administration fee to the same four insurances listed below for staff. Again, if your child does not have insurance or not one of the insurances listed below, they may still get the flu shot at no cost. If your child will be receiving the flu shot at school, it must be on the above date they are normally scheduled to be in school. The Public Health Department is at the school as a courtesy; you can choose to take your child to their PCP or local pharmacy for their flu vaccine.
For STAFF, please make sure to complete the insurance portion of the form or have your insurance card with you. We are able to bill Anthem, Cigna, Harvard Pilgrim and MCHO for the cost of the vaccine. If you do not have one of these insurances, we ask that you visit your doctor’s office or pharmacy. If you
prefer to receive the vaccine, we are able to offer the flu vaccine for $25.
PLEASE SUBMIT THE COMPLETED HEALTH SCREEN PERMISSION FORM TO SCHOOL NO LATER THAN TUESDAY 10/20/20 if you choose to have your child receive the Flu Vaccine.
The public health department asks that everyone wear a face covering while receiving the vaccine; if you do not have one, we will provide one. We ask for your patience, as we will need to sanitize between each client while the clinic is going on.
Thank you,
Debbie Dwyer BSN, RN
School Nurse
Center Drive School
ph: 207-825-3697
The Bangor Public Health staff will be offering flu shots to students and staff at CENTER DRIVE SCHOOL on:
Tuesday, October 27 th , from 11:00 AM – 1:00 PM
Monday, November 2 nd , from 11:00 AM – 1:00 PM
For STUDENTS, the flu vaccine will be provided at no charge to all students. We ask that parents/legal guardians legibly complete the insurance information, as the Bangor Public Health Department is able to bill a small administration fee to the same four insurances listed below for staff. Again, if your child does not have insurance or not one of the insurances listed below, they may still get the flu shot at no cost. If your child will be receiving the flu shot at school, it must be on the above date they are normally scheduled to be in school. The Public Health Department is at the school as a courtesy; you can choose to take your child to their PCP or local pharmacy for their flu vaccine.
For STAFF, please make sure to complete the insurance portion of the form or have your insurance card with you. We are able to bill Anthem, Cigna, Harvard Pilgrim and MCHO for the cost of the vaccine. If you do not have one of these insurances, we ask that you visit your doctor’s office or pharmacy. If you
prefer to receive the vaccine, we are able to offer the flu vaccine for $25.
PLEASE SUBMIT THE COMPLETED HEALTH SCREEN PERMISSION FORM TO SCHOOL NO LATER THAN TUESDAY 10/20/20 if you choose to have your child receive the Flu Vaccine.
The public health department asks that everyone wear a face covering while receiving the vaccine; if you do not have one, we will provide one. We ask for your patience, as we will need to sanitize between each client while the clinic is going on.
Thank you,
Debbie Dwyer BSN, RN
School Nurse
Center Drive School
ph: 207-825-3697
health_screen_permission_form_2020_cds_dedham.docx |
health_screen_permission_form_2020_cds_dedham__1_.pdf |