Immunization Clinic Forms
If you need immunizations from the Health Department, you may fill out the paperwork before your visit.
HIPAA Privacy Brochure English
HIPAA Privacy Notice Spanish
Immunization Screening Questionnaire
CHS1A Consent for Health Care
CHS1A Consent for Health Care Spanish
Whooping Cough
TDAP Registration Consent Form English/Spanish
Immunization Hours (including flu)
Prince William Health District, 9301 Lee Avenue, Manassas, VA. 20110, 703-792-6300
Monday from 8 - 10:30 a.m. and Friday from 8 - 10:30 a.m.
Prince William Health District, 4001 Prince William Health District, 4001 Prince William Parkway, Suite 101, Woodbridge, VA. 22192, 703-792-7300; Monday from 12:30 - 2:30 p.m. and Wednesday from 8:15 - 10 a.m.
*The cost of the flu vaccine is $30.00.