Flu Shots Available at Jesuit on Tuesday, Oct. 28
Flu vaccinations will be available to the Jesuit community in the Student Commons on Tuesday, Oct. 28, from 7:15 a.m. to 4:00 p.m.
For all students, parents, relatives, other members of the Jesuit community (other than faculty or staff using BCBS) who wish to receive the vaccine, a flu shot will be $30 and flu mist will be $40. You may pay either with cash or personal check made out to MHM Urgent Care Mid-City. Jesuit faculty and staff may use their Jesuit BCBS policy to cover payment (see below for details).
Review the 2014-2015 Flu Vaccination Information sheet from the CDC.
Requirements to Receive Flu Vaccination
To receive the vaccination, you must submit a copy of picture ID, payment, and two completed forms. Details are below.
Students, Parents, Relatives, Members of the Jesuit Community (Not Faculty & Staff Using BCBS)
- Copy of your picture ID (parent’s ID for minors).
- Payment of cash or check made out to MHM Urgent Care Mid-City. ($30 for Flu Shot or $40 for Flu Mist)
- Patient Information Form (PDF). Complete the Flu Vaccine Patient Information section and be sure to sign and date the bottom of the form. You do not need to fill in the insurance section of this form.
- Flu Shot Consent Form (PDF) or Flu Mist Consent Form (PDF): Complete sections A, B, and C on the flu shot or flu mist consent form.
Faculty & Staff Using Jesuit BCBS
Faculty and staff members using their Jesuit BCBS insurance policy should follow these instructions.
- Copy of your picture ID.
- Copy of the front and back of your BCBS insurance card.
- Patient Information Form (PDF). Complete all sections including the Flu Vaccine Patient Information, Insurance, and Policy Holder Information/Responsible Party sections, and be sure to sign and date the bottom of the form.
- Flu Shot Consent Form (PDF) or Flu Mist Consent Form (PDF): Complete sections A, B, and C on the flu shot or flu mist consent form.