FluClinic Tool Kit
FluClinic Tool Kit
Wellness & Vaccinations
Thank you for choosing us as your FluClinic partner! We are delighted to be of service to your organization.
Below you will find required documents and information to make your organization's FluClinic a success! In order to encourage 100% participation in your vaccination program, we recommend the following:
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Promote your clinic 3-4 weeks in advance
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Provide frequent reminders via posters, emails, texts, and voicemails
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Use a raffle or other incentive to encourage clinic participation
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Provide access to information about the Influenza
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Delegate an individual to promote the FluClinic to others
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Download additional resources like videos, web tools and mobile content at www.cdc.gov to support your clinic
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Consider adding a VNA wellness screen to your clinic
Required Patient Documents
Please note that accepted health insurance providers include: Aetna, Anthem - Blue Cross and Blue Shield (NO EPO's), Cigna (NO EPO's), Coventry, Essence, HealthLink, Humana, United Healthcare - including AllsSavers, GoldenRule, UMR & GEHA
Medicare Plans: Medicare Part B, Anthem Blue Cross & Blue Shield Advantage HMO & PPO, Essence
Medicare Advantage Plans PPO ONLY - NO HMO: Aetna, Cigna Medicare Access, Coventry, HealthLink, Humana, United HealthCare - including PPO AARP
Missouri Medicaid for 18 Years & Younger ONLY: Home State Health, Missouri Care, United HealthCare Community Plans, Health Blue, Ambetter, MO Healthnet
VNA cannot accept Medicaid plans for those over the age of 18.
Please have your insurance card available at your scheduled appointment.
2022 Flu Consent Form
Age 18 and Older
2022 Flu High Dose Consent Form
Age 65 Years and Older
Vaccine Information Statement Influenza
2022 Flu Consent Form
Age 3 to 17 Years Old
2022 Flu Preservative Free Consent Form
Age 6 Months and Older
Vaccination Clinic Information & Promotion Material
Stay Healthy for What Matters Poster - 8.5"X11"
Influenza is Serious Flyer
Fight the Flu CDC Flyer