Flu Watchers - Your Corporate Vaccination Advocate
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Provider Registration
NY State Provider Registration

 

We are accepting applications from Licensed Flu Vaccination and Cholesterol-Glucose providers for NY State.  To register, complete the form below and submit it for approval.  Your information may be provided to corporations who are looking for licensed providers for their area.

 Proof of licensing will be required upon application acceptance.

First Name:
Company Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Alternate Phone:
Email:
Licensing Confirmation:

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