Influenza Vaccination Appointment Request

This form is to request a vaccination against influenza.

This form can only be submitted by patients who are between the ages of 18 and 64 who are in a clinically at risk group. You would have been sent an SMS message last week telling you that you can apply for an appointment.

We will email or SMS you your appointment time and send you instructions.

Once again, we have secured the South Stand of Norwich City Football Ground.

Vaccinations will take place on Saturday 2nd October 2021.

Please wear a face covering when attending the appointment. Do contact us and let us know if you are unwell or have COVID-19 symptoms. If you have been tested positive for COVID-19 after 19th September 2021 do not attend.

Please do try and keep to your allocated time.

Influenza Vaccination Appointment Request

Section

Eligibility

This is for patients registered with Magdalen Medical Practice.

Availability

This is for an Influenza vaccination.

The clinic is being held in the South Stand at Carrow road football stadium on Saturday 2nd October 2021.

Please specify your preferred time:

We will endeavour to accommodate your request.

Ethnicity

Please specify the ethnic group you consider you belong to: *

Terms and Conditions

*