Clinic SignUp Information

Yukon Public Schools Student and Family Clinic
Flu and COVID vaccines Please bring a mask. All individuals 12+ are now eligible to register for the COVID-19 vaccine. Please note that Pfizer is approved for ages 12 or older and Moderna/Janssen is approved for ages 18 or older. A parent or guardian must be present at the time of the appointment for anyone under the age of 18. While we will try to honor vaccine type requests, first dose choices may be limited based on vaccine availability. Third dose boosters of Pfizer are now available for certain individuals who received their second dose at least 6 months before their appointment. This includes anyone over the age of 65 and people who are at increased risk due to underlying health condition or increased risk due to occupation. To read more on who is now eligible for Pfizer boosters please read CDC recommendations at the following link: CDC Statement on ACIP Booster Recommendations Please be sure to bring your white CDC vaccination card with you to your appointment if you are registering for a second or third dose of any COVID-19 vaccine! If you have already received your first dose with another provider and are due for a follow up, you are welcome to register for your second dose at this location. Please dress with consideration to having your upper arm exposed. We suggest a short sleeve shirt, if possible. A post-vaccine monitoring period of at least 15 minutes is required. After registration - download & bring completed consent form to your appointment. Extra consent forms are available at check-in if you do not have access to a printer. Bring your health insurance card or a clear copy of both sides of the card. If you do not have health insurance you can receive COVID vaccine at no charge. For all others, cash, check, or credit are accepted forms of payment. DO NOT ATTEND THIS EVENT IF ARE FEELING SICK INCLUDING FEVER, COLD OR FLU LIKE SYMPTOMS, OR TESTED POSITIVE FOR COVID IN THE PREVIOUS 14 DAYS
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COVID-19 Appointment Type
Services I'd like to receive	COVID-19 Vaccine Flu High Dose Flu Shot (for ages 65+) Pneumonia Shingles TDaP

You will receive those immunizations as medically indicated by your health consultant staff. Vaccine Information Statements are available online here.

Need help? Contact us at myclinic@passporthealthok.com

Passport Health is committed to keeping your personal data safe and we endeavor to take every reasonable precaution to ensure security. Passport Health complies with health care data reporting requirements of State and Federal authorities, as well as subpoenas, and may use or disclose data as required or requested for billing and payment purposes. Outside of this, access to your personal information is restricted to employees at Passport Health for internal purposes only and is never sold.

I consent to receiving immunizations from Passport Health. I have been given an opportunity to review the Vaccine Information Statements located here. At the time of my appointment I will be made aware of certain risks that may be associated with the vaccine(s) including the potential for allergic reaction and I will be offered the opportunity to ask questions and I believe that the benefits outweigh the risks. I assume full responsibility for any reactions that may result. I authorize Passport Health to disclose my health information to my state immunization registry, my physician, my employer and my insurance company. I authorize Passport Health to notify me of future health events, services or products. I hereby acknowledge receipt of Passport Health's Notice of Privacy Practices. If I am signing this consent on behalf of another individual, I hereby certify that I have the legal right to do so as the person's parent or legal guardian, pursuant to a health care power of attorney, pursuant to a court order, or pursuant to some other legal right to consent to health care for the individual. I agree that the insurer or payer listed above is my primary medical coverage and that I am responsible for payment if services are not covered for any reason or are subject to any co-pays, deductibles, coinsurance or prior authorizations.

Flu and COVID vaccines