Offsite Flu Vaccine EOI

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This field is for validation purposes and should be left unchanged.
Business Name (Required)*
Contact person (required)*
First Last
Business Address (Required)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Business phone number (Required)*
Business Email (Required)*

Please enter the best email to contact regarding the flu vaccination service.
Approximate number of employees*
This is just for indicative purposes, there is no obligation based on this number.
Does at least 1 member of your organisation hold a current First Aid and CPR Certificate?
- Yes
- No
Legislation requires 2 people to be on-site with current First Aid/CPR certificates. Our trained pharmacist vaccinator will be one, but if your organisation is unable to provide the second, an additional administration charge may apply to cover a second pharmacy employee attending.
Other Information
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