Mercy Families,

  
Once again Mercy will host a free influenza clinic on Tuesday, October 6th, 2015 in partnership with the Michigan Community Wellness Visiting Nurse Association  (VNA) and Alana's Foundation. The foundation was established in 2009 in memory of then five year old Alana Yaksich who died of influenza in 2003.
 

The clinic will be held from 12:30-3:30 pm in Mercy's lobby (Auditorium/Gym Lobby Area) on October 6th and is available to students, staff, and families of Mercy. It does, however, require advance registration for each person who wishes to receive the vaccination here on October 6th. We have provided all of the information you need. See the flyer, the Vaccine Information Statements (for both Flu Injectable and Intranasal Flu Mist), and the Notice of Privacy Practices. Please print, complete and return the Assessment and Consent Form to the Reception Area no later than Tuesday September, 22, 2015.
 

A separate consent form must be completed (in its entirety) for each person who will be vaccinated. Parents must complete and sign the form for anyone under the age of 18.
 

All consent forms are required in advance because the VNA must determine the actual number of doses needed for the day of the clinic. The flu mist will be used whenever possible but the nurse will make the determination in cases where the injectable is more appropriate (i.e. anyone over age 49 is ineligible to receive the FluMist).
 

Please note: On the day of the flu clinic, any person who has pre-registered will need to present a picture ID and the insurance card (or a copy of the insurance

card) in order to receive the vaccination. Vaccinations will not be given to anyone whose consent form is incomplete or unsigned. Most insurance companies cover the cost of the vaccination but Alana's Foundation will cover the cost for anyone without any insurance.
 

Mercy is happy to offer our facility for this clinic. We hope you will take advantage of the opportunity for your daughter(s) and/or yourself. Please consult with your family physician regarding any questions about the vaccine.
 

Sincerely,