- Bill Medicare and/or HMO’s for most shots
- Dispose of all Medical waste
- Provide each person a copy of their consent form
for their records
After the unforeseen
shortages in 2004, and the development of a new strain in the vaccine this
year, we are reaching out to churches, community centers, nursing homes,
assisted living facilities, and retirement communities. Our goal is to educate
everyone about influenza and offer a solution to get vaccinated.
Each flu clinic is unique and
your opportunity to reach out
to the community. Also, you may not know that Maxim is the company that
provides flu clinics in most grocery stores and pharmacy stores nationwide. Some
of our partners include Publix, Walgreens and
To take advantage of this
opportunity simply complete the flu clinic request form and I’ll contact you
immediately. Or if you just want to
learn more about Maxim Health Systems call or email me today!
I look forward to speaking
with you soon!
Sincerely,
Randall Reasbeck
Accounts Manager
About Maxim Health Systems - Maxim
Health Systems is a division of Maxim Healthcare Services, Inc. Established in 1996, Maxim Health Systems
offers a full line of comprehensive wellness services to corporate and retail
clients. We provide a variety of
services including immunizations, health screenings and health fairs. In 2004, our flu immunization program alone
was responsible for vaccinating more than 1.8 million people. Together with Maxim Healthcare Services, we
have branch locations in most metropolitan areas across the nation. For more
information visit us at www.FindAFluShot.com
Flu Clinic Request Form
Email completed form
to jahatche@maxhealth.com or fax
form to
Maxim Accounts Manager: Beau Hatcher (501) 223-2300 or (866) 471-5678
Contact
Name:
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Contact
Phone Number:
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Contact
Email address:
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Name
of Church:
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Date
– 1st choice: |
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Date
– 2nd choice: |
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Date
– 3rd choice: |
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(Maxim can
begin giving flu shots (Maxim can
accommodate any day or time of the week) |
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Flu
Clinic Start Time: Flu
Clinic End Time: |
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Would
you like multiple clinics? |
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Location
of clinic - Bldg./Room: |
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Address: |
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#
of total members: |
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(30 shot
minimum per clinic) |
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Has
the church offered flu shots in the past?
If yes, how many shots were given? |
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Will
non-members be invited to the clinics? |
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Will
church be paying for employees’ flu shots? |
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Special
notes or considerations: |
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Directions
to location and parking instructions: |
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