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2009 FLU CORPORATE CLIENT SERVICE AGREEMENT

St. John’s Mercy Corporate Health agrees to provide influenza immunization service(s) for your Flu Clinic, according to the following conditions:

1. See attached Clinic Confirmation for negotiated costs* of vaccines and services and estimated number of participants.

• GHP, Mercy, Medicare Part B and some Medicare Advantage Plans accepted. A list of current accepted insurances will be available for download on our web site September 15.

• If invoiced, payment is due within 14 days of receipt.

2. It is important that you provide us with an accurate count of participants so that we may order the appropriate amount of vaccine. Since Flu vaccine is not returnable, SJMCH is at risk to incur financial losses due to wasted doses. In order to manage costs, please help us by providing at least 75-100% of your projected reserved amount as indicated by you below.

3. If you want the nurse to stay beyond the scheduled time:

• Notify us immediately.

• An additional $50 per hour per nurse may apply.

4. All pregnant women who receive the flu vaccine must receive a Preservative Free flu shot.

• Notify us 2 weeks prior to your clinic indicating number of doses needed.

• Preservative Free flu vaccine is $40 per dose.

5. Notice of cancellation must be received not later than 48 hours prior to schedule date.

• If notice is received < 48 hours, a fee of $50 dollars will be due.

6. General Information

• You will be contacted by a SJMCH coordinator at least 30 days prior to your scheduled date to review your clinic needs and answer questions.

• Flu Vaccine can be administered to anyone age 9 years or older.

• We will need a location, a conference or lunchroom, accessible only to employees receiving immunizations, 1 table, chairs, and wastebasket. For those that require privacy, a private area nearby would be helpful.

• Free...