Pima County Flu Shot Program
Clinic Location
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You will receive those immunizations as medically indicated by your health consultant staff. Vaccine Information Statements are available online here.

If you do not have insurance, we can still provide you a flu shot at no cost
Services I'd like to receive
Medical History Questions
Yes No Is this your first flu vaccination?
Yes No Have you ever had an anaphylactic reaction, such as hives, wheezing, difficulty breathing or circulatory collapse related to latex?
Yes No Have you ever had an anaphylactic reaction, such as hives, wheezing, difficulty breathing or circulatory collapse related to chicken eggs, egg products, neomycin, gelatin or yeast?
Yes No Have you ever had an anaphylactic reaction, such as hives, wheezing, difficulty breathing or circulatory collapse related to thimerosal, which is found as a preservative in contact lens solution and some vaccines?
Yes No Do you have any history of Guillain-Barre Syndrome or paralysis?
Yes No Are you pregnant or breast feeding?

Insurance Billing Information

Insurance Provider
 



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