MLC Flu Shot Clinic 2016

It’s that time of year again — time for your yearly flu shot. There will be two flu shot clinics at MLC this fall in the LSC (Luther Student Center) near the concession stand area:

Wednesday, November 2nd from 10:45am-12:15pm


Tuesday, November 8th from 10:45am-12:15pm

Flu vaccinations are available not only to faculty, staff & students, but also to family members and Emeritus. Getting an annual flu vaccine is the first and best way to protect yourself and your family from the flu. Flu vaccination can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations. The more people who get vaccinated, the more people will be protected from flu, including older people, very young children, pregnant women and people with certain health conditions who are more vulnerable to serious flu complications.

Listed below are the forms you will need to have filled out and turned in at the flu shot clinic. Forms need to be completed for each person receiving a flu vaccination. Allina will bill your health insurance, so there is no cost to you the day you receive your vaccination (Most insurance companies are required to cover the cost of a flu vaccination). If you do not have health insurance or would rather pay cash the cost of a flu vaccination is $21. Please bring exact change. 

  1. The Vaccine Information Statement is for your information only and does not need to be printed and submitted. vaccine-information-statement-2
  2. English Flu Questionnaire 2016 documentenglish-flu-questionnaire-2016
  3. Assignment of Benefits- highlighted areas need to be completed. After you sign this document write the date and time of your signature down otherwise the document will be invalid.assignment-of-benefits-form-pdf-1
  4. Consent for Release of Information also needs to be printed, completed and turned in.  Again, please be sure to write the date and time after your signature.  consent-for-release-of-information-1

Allina will need a photocopy of insurance cards as well. Please have a photocopy of your insurance card ready ahead of time as there is not a copy machine available at the flu shot clinicin the LSC.

For more information on Flu Vaccines please visit the CDC website at:

If you have any questions don’t hesitate to ask.

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