MSAD 15 Annual Flu Clinic : October 18th, 19th, 20th

Your child’s school will be having an influenza vaccination clinic on October 18, 19 and 20th.  We will be partnering with Northern Light Home Care & Hospice to provide this clinic to our students.

Please click on the link below and complete the consent form by Wednesday, October 13th, 2021.  You must type something into all highlighted fields, so please use NA if it doesn’t apply. Although the vaccine is provided at no charge, there is a cost to administer the vaccine. We appreciate it if you include accurate insurance information. Children presenting with an incomplete form will not receive their vaccine. There is no out of pocket cost and those without insurance will be vaccinated with the appropriate form completed.

RSU 15 Influenza Consent

  • You will be notified if there is a change in the planned dates of school flu clinics.
  • The Vaccine Information Sheets are included in the link after the consent form. Please take a minute to read these.
  • If you need a translated form or are unable to complete an electronic form, please let the school nurse know and we will send a paper form home.

All clinics will have injectable vaccine. In addition, FluMist (nasal spray) may be available at some clinics.  We cannot guarantee it for all clinics. Unless you clearly mark which type of vaccine you prefer, and there is no contraindication to either type of vaccine, the nurse at the clinic will determine which type of vaccine to use for your child.

For information about flu and the vaccine go to www.maineflu.gov

For questions about the flu vaccine, call Maine Center for Disease Control & Prevention (Maine CDC) at 1-800-867-4775, Monday through Friday, 9 am – 5 pm.

For questions about the vaccine clinics at our school, please call the school nurse at the school health office where your child attends school.


Tonia Gilley-Pratt RN, BSN

Please be sure to complete and return the Health Screen & Permission form!