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PEEHIP Wellness and Flu Vaccine Information

STUDENT Information:

Alabama Department of Public Health will offer the Flu Shot to students age Pre K-4 years through 12th grade that have PEEHIP Insurance (BC/BS insurance number that begins with EDU).  This school vaccination program is voluntary and parents must complete the attached permission form and return to the school nurse one week before the school clinic.   

Parent Reminders for filling out flu form:
1. Please use black ink only!
2. Please make sure all boxes are filled out correctly. 
3. Under patient information please make sure to put the last four of the child who is receiving the vaccine's social. Not the parents. 
4. Please answer all of the yes/no questions. 
5. Please sign and date form. The vaccine can not be administered without a signature. 
6. Forms must be original and turned into the Alabama Department of Public Health Vaccination team by the school nurse on the day of clinic. We can not accept emailed or faxed copies. Must have that original signature.   

 PEEHIP Student Flu Vaccine Form



EMPLOYEE Information:

Alabama Department of Public Health will offer a free wellness screening and Flu vaccine to employees on their school campus during the month of October and  November.  The wellness screening is a requirement for employees and spouses covered under PEEHIP Blue Cross and Blue Shield Insurance in order to avoid a monthly increase in insurance premiums.  This year employees will need to sign up online to set up their wellness appointment.  Employees may also schedule the wellness screening with their physician or sign up online at the Health Department.  

If employees have difficulty signing up online for an appointment time please contact Myranda Barrett, RN, Wellness, Alabama Department of Public Health at 256-765-7513 or Lillian Clayton at 256-764-7453.

The Flu vaccine is available but not a requirement of the wellness screening.  The Flu vaccine employee consent form is a carbon copy and must be completed at the time of the wellness screening.  Staff that only want to participate in receiving a Flu Shot do not need to make an appointment.

 PEEHIPP Employee Flu Vaccine Form

ADPH Online Calendar- Schedule Appt Here




(Appointments for Wellness Screenings need to be made online)





Oct 5

Lauderdale Co School

8:30-11, 12:15-3:00


Oct 7

Lexington School

8:30-11, 12:15-3:00


Oct 13

Underwood Elem



Oct 14

Waterloo School



Oct 20

Rogers School

8:30-11, 12:15-3:30


Oct 21

Wilson School

8:30-11, 12:15-3:30


Oct 25

Central School

8:30-11, 12:15-3:30


Oct 27

Brooks HS

8:30-11, 12:15-3:00


Oct 29

Brooks Elem

8:30-11, 12:15-3:00


Nov 1

Allen Thornton School