Flu Certificate Order Form

Your company may purchase Fight the Flu certificates for employees to use at any Inova public clinic or urgent care location. For more information and a complete list of public clinic and urgent care locations, please visit our website: inova.org/flu.

Certificates offer the following advantages:

1. For companies with multiple locations, certificates eliminate the need to gather employees in one location to hold a work-site clinic. 2. Smaller companies who cannot meet their participation requirement for any on-site clinic may purchase certificates to offer the flu shot benefit to their employees. 3. Employees may receive the vaccination at numerous locations throughout the Northern Virginia area at their own convenience (only valid at Inova locations).

Company Name*

Contact Person*

Address*

City*

State*

Zip*

Phone*

(000-000-0000)

Email*

Number of Certificates*

Order Date*

Additional Information

Please note:

Certificate orders will be processed and mailed within 72 business hours and will be accompanied by an invoice. Each certificate's cost will be billed at your corporate rate. There is no additional charge when the certificate is redeemed. The Fight the Flu campaign operates September 2020 through February 2021. There is no minimum purchase. Companies may purchase as few or as many certificates as needed. Certificates are non-refundable.

Notes/Comments

Send me a copy of my responses

Privacy Notice|Report Abuse