SANDERS MONTANA WASH YOUR HANDS, COVER YOUR COUGH, and GET YOUR FLU SHOT! Sanders County Public Health Department Flu Clinic schedule - All ages welcome SENIOR CENTER CLINIC SCHEDULE 65+ High-Dose avail while supply last PLAINS SENIOR CENTER 205 Meany St October 26th 11 am - 1 pm. THOMPSON FALLS SENIOR CENTER 1191 Mnt Silcox Dr October 13th 4:30 pm - 6:00 pm TROUT CREEK SENIOR CENTER 18 Larch St October 11th 4:30 pm - 6:00 pm HOT SPRINGS SENIOR CENTER 101 Main St October 12th 11:00 am - 2:00 pm COUNTY NOXON SENIOR CENTER 207 2nd St October 17th 4:30 pm - 6:00 pm HERON SENIOR CENTER 27 Railroad Ave October 19th 4:30 pm - 6:00 pm DRIVE THRU CLINIC SCHEDULE TROUT CREEK Fire Station Hall (Trout Creek park) October 11th 12 pm - 3 pm THOMPSON FALLS Community Center (410 Golf St) October 6th 12 pm - 4 pm PLAINS Fairgrounds (30 River Road W) October 26th 2 pm - 4 pm WALK-IN CLINIC Sanders Public Health Dept. 1111 Main Rm # 120, Thompson Falls Mondays only 8 am- 4 pm (closed 12-1) (starting on 10/3) Please complete the form below and bring to the flu clinic For any questions please call the Sanders County Health Department at 406-827-6931. I give my permission to receive a flu vaccine from the Sanders County Public Health Department. Please wear appropriate clothing (short sleeve shirts) to allow access to arm. Signature: Name: Date of birth: Mailing Address: Phone number: - Insurance/health coverage information. Medicare # Supplemental Insurance # Date: - Health Insurance Company (BlueCross BlueShield, Allegiance, Tricare, United Health Care, etc) Name: Member #: Company contact Phone #: Group #: Medicaid (HMK Plus) Member ID# Do not have health insurance coverage I authorize the Sanders County Public Health Department to enter my flu vaccine into the Immunization Information System (IIS). The IIS is a confidential, computer system that contains immunization records that medical facilities/ providers will be able to see. Signature: SANDERS MONTANA WASH YOUR HANDS , COVER YOUR COUGH , and GET YOUR FLU SHOT ! Sanders County Public Health Department Flu Clinic schedule - All ages welcome SENIOR CENTER CLINIC SCHEDULE 65+ High - Dose avail while supply last PLAINS SENIOR CENTER 205 Meany St October 26th 11 am - 1 pm . THOMPSON FALLS SENIOR CENTER 1191 Mnt Silcox Dr October 13th 4:30 pm - 6:00 pm TROUT CREEK SENIOR CENTER 18 Larch St October 11th 4:30 pm - 6:00 pm HOT SPRINGS SENIOR CENTER 101 Main St October 12th 11:00 am - 2:00 pm COUNTY NOXON SENIOR CENTER 207 2nd St October 17th 4:30 pm - 6:00 pm HERON SENIOR CENTER 27 Railroad Ave October 19th 4:30 pm - 6:00 pm DRIVE THRU CLINIC SCHEDULE TROUT CREEK Fire Station Hall ( Trout Creek park ) October 11th 12 pm - 3 pm THOMPSON FALLS Community Center ( 410 Golf St ) October 6th 12 pm - 4 pm PLAINS Fairgrounds ( 30 River Road W ) October 26th 2 pm - 4 pm WALK - IN CLINIC Sanders Public Health Dept. 1111 Main Rm # 120 , Thompson Falls Mondays only 8 am- 4 pm ( closed 12-1 ) ( starting on 10/3 ) Please complete the form below and bring to the flu clinic For any questions please call the Sanders County Health Department at 406-827-6931 . I give my permission to receive a flu vaccine from the Sanders County Public Health Department . Please wear appropriate clothing ( short sleeve shirts ) to allow access to arm . Signature : Name : Date of birth : Mailing Address : Phone number : - Insurance / health coverage information . Medicare # Supplemental Insurance # Date : - Health Insurance Company ( BlueCross BlueShield , Allegiance , Tricare , United Health Care , etc ) Name : Member # : Company contact Phone # : Group # : Medicaid ( HMK Plus ) Member ID # Do not have health insurance coverage I authorize the Sanders County Public Health Department to enter my flu vaccine into the Immunization Information System ( IIS ) . The IIS is a confidential , computer system that contains immunization records that medical facilities / providers will be able to see . Signature :