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Keep your business immune from influenza in 2008

Immunising your staff against winter influenza is the best weapon you have to reduce the cost of absenteeism to your organisation

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INFLUENZA VACCINATION BOOKING ENQUIRY

Your company name:
Health For Industry
client number (if known):
Location:


Contact person details

Name :
Phone:
Email:


Influenza vaccination program requirements

Site 1  
Address:

Number of staff requiring vaccination (minimum of 20 for a workplace visit):

   
Preferred dates: Preferred times:
1st option: 1st option:
2nd option: 2nd option:
3rd option: 3rd option:

Site 2  
Address:

Number of staff requiring vaccination (minimum of 20 for a workplace visit):

   
Preferred dates: Preferred times:
1st option: 1st option:
2nd option: 2nd option:
3rd option: 3rd option:

Site 3  
Address:

Number of staff requiring vaccination (minimum of 20 for a workplace visit):

   
Preferred dates: Preferred times:
1st option: 1st option:
2nd option: 2nd option:
3rd option: 3rd option:


If you have more than 3 sites, either call 1300 653 523 or submit additional booking enquiries.

Questions or Special Requirements

How did you hear about Health for Industry's Influenza Vaccination Program?

Online
Mail out
Brochure
Word of mouth
Other (please specify):

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