Before receiving a routine or travel immunization, each patient must fill out one of these forms.
Please note that this form must be filled out on the day of your appointment.
Adult Immunization Questionnaire
Pediatric Immunization Questionnaire
GVSU Family Health Center
72 Sheldon Blvd SE
Mike Burritt, Practice Manager
M,T,TH,F 9:00a - 5:00p
W 10:00a - 6:00p