Submit Proof of Vaccination

If you receive your annual vaccination through another source or you selected your own provider for the shot please provide NPLH with a copy of the vaccination record to satisfy your requirement.

If you paid out of pocket for the shot attach your receipt along with your vaccination record for reimbursement (up to $25).

Please click below to print a fax cover sheet to send with your flu vaccine record.

If you have any questions please contact Terricca