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CRAHD
Consent Form

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Vaccine Information Statement (VIS)

Please bring your insurance card and a State ID

We accept the following Insurances:

• Anthem BC/BS • Connecticare • CIGNA • Medicare • Anthem BC/BS Medicare • Connecticare Medicare
• CIGNA Medicare 

18yo and under are not required to have insurance information and will receive a vaccination at no cost. Others may still receive a vaccination without insurance or if you have a different insurance

Cost – Quadrivalent $35 Senior Dose $65

Cash or Check Payable to: CRAHD

CRAHD vaccinates ages 4 years old and up. Individuals under 18 must be accompanied by a parent or legal guardian

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                                                     FLU Vaccinations 2022                                                            Please call: 860-661-3300 to schedule