Flu Shot Forms

Friends don't let friends NOT get a flu shot! Below is a list of our flu shot clinics for 2012. Please open and print the online forms for your convenience which are in English and Spanish. Remember, these shots will last for one year and you will not need more than one flu vaccine.

Drive Through Flu Shot Clinics
Wednesday, October 3
5 - 6:30 pm
Sioux Center Medical Clinic South Parking Lot (Approach from the west on 7th St.)

Flu Shot Clinics:  Sioux Center & Hull Medical Clinics
Wednesdays, October 3, 10, 17 & 24
7:30 am – 5 pm
Sioux Center & Hull Medical Clinics

Cost for the flu shot is $30 for those 3 years and older, and is $40 per dose for those 6 months to 35 months as two doses may be recommended. Cost for the Flumist is $55.

For your convenience, you may download forms to complete prior to your arrival at the clinic. Fill out the consent form in advance and bring it with you to the clinic. And learn more about the flu shot and the flu mist.

Injectable influenza vaccine consent form

Flumist vaccine consent form

Spanish Forms

Flu Shot

Flu Mist

Injectable Influenza Consent Form

Flumist Vaccine Consent Form