Genesis Flu Free Quad Cities @ GW - Oct. 11

Genesis Flu Free Quad Cities @ GW - Oct. 11

Sep 27, 2016

Consent Form | Vaccine Information | Genesis Privacy Policy

Genesis will be offering FREE seasonal flu vaccines at your BCSD elementary schools this fall. The Genesis Flu-Free Quad Cities program is sponsored by: Genesis Health Services Foundation, Clinton County VNA Foundation and gifts from individual and corporate private donors in our communities. Vaccination is one of the best ways to protect your child against the flu. Our goal is to keep your children and those they come in contact with, healthy this flu season!

Vaccines will be administered at Grant Wood on October 11.

  • If you would like your child to receive a free seasonal flu vaccine at school, we need your permission.
  • COMPLETE the consent form. It is important that you answer ALL of the questions and SIGN and DATE the form. ONLY legal guardians and parents should sign.
  • Return the completed consent form to the school.
  • If you do not wish for your child to have the vaccine, DO NOT fill out or return the consent to the school.

The Vaccine Information Statement (VIS) may be on your school district website or you may view the VIS on the following site: or Please take time to read this information. It should answer any questions you may have about the flu vaccine.

This program does not include a second clinic at your child's school for those children that may require a second vaccine. The information sheet that your child will bring home after their vaccine will help you determine whether your child will need a second vaccine. Your local health department or primary care physician will be able to assist you as well.

If you have any questions regarding Genesis Flu-Free Quad Cities program, please contact Dee Tipton (563) 244-4939/Michele Cullen (563) 244-4923 or (563) 242-7165. Thank you for helping to make your child's school and community a healthier place.

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