Beyond Vision

Flu Shot Clinic 2020

Beyond Vision Colleagues,

I’m pleased to announce that we will be having a Flu Shot clinic at Beyond Vision on Friday, September 18 from 10am to noon. Save a trip to your doctor and get your flu shot at work!

The Flu Shot clinic will be administered by Advocate Aurora Health who accepts private insurance as well as Medicare and Medicaid. Unfortunately Aurora is NOT in network for Network Health so this insurance carrier would not cover the shot through this clinic. You can also pay out of pocket for the shot which costs $35. High dose shots will be available in addition to the regular dose.

If you would like to sign up for a time slot, please contact me via email or by leaving a message on my extension, 5866.

You will need to bring the following completed forms to your appointment. Let me know if you need assistance in completing the forms.

  • Flu Shot Consent Form – which allows them to give you the flu shot. The participant does not receive a copy, so if you need proof of the flu shot you can access that information on the Wisconsin Immunization Registry or you can ask to make a copy of the consent after it is completed by the nurse. When you click on the Consent PDF you will see an attachment on the left to view the Vaccine Information Sheet.
  • Notice of Privacy Practices Acknowledgment Form – which states you were provided access to Aurora’s Privacy Practices (HIPPA) information.  I have attached the Notice of Privacy Practices.
  • Smart Chart Registration Form– This gives them the necessary information to bill your insurance company.
  • Medicare Secondary Payer Questionnaire – only needed by those using Medicare to pay for the shot

In addition to the above forms, you also need

  • A Photocopy, front and back, of you insurance ID card to give to the nurse that day.

Feel free to contact me if you have any questions.

Lani Knutson