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UT Dallas

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You will receive those immunizations as medically indicated by your health consultant staff. Vaccine Information Statements are available online at http://www.cdc.gov/vaccines/hcp/vis/current-vis.html.

REGISTRATION IS REQUIRED DUE TO LIMITING THE NUMBER OF SHOTS THIS YEAR TO ACCOMMODATE CLEANING AND SOCIAL DISTANCING REQUIREMENTS. WALK-INS CANNOT BE ACCOMMODATED DUE TO EFFORTS TO MAINTAIN SOCIAL DISTANCING.

Completion of the daily health screen will be required prior to coming to campus.

Consent forms must be completed prior to the clinic. Please have completed paperwork and photocopy of both your insurance card and driver's license with you when you arrive. We cannot make copies for you.

Face masks must be worn during the clinic.

We are able to accept the following PPO insurances:

• Blue Cross Blue Shield**
• Aetna**
• Cigna*
• Humana
• United HealthCare
• Medicare Part B (provide a copy of any supplement plans also)

We are unable to accept HMO plans.

*We are unable to accept Cigna Local Plus plans.
**We are unable to accept Aetna & Blue Cross Gold, Silver or Bronze plans.

Most plans cover immunizations at 100%. Please see the consent form for known exceptions.

For UT Dallas Employees without one of our accepted insurance plans, UT Dallas will pay for your flu shot.

Students and retirees without an accepted insurance can pay for a flu vaccine for $20, cash only.

B12 injections are available for $18 and must be paid by cash at the time of service.

If you are using insurance for your immunizations you must bring a photo copy of your insurance card to the clinic.

After you register you will see a confirmation page containing a link to a consent form. Please bring this filled out along with your photo copies. Registration times are requests and not guaranteed. You should still expect a short wait during the clinic.

Vaccinations are given in the upper arm. Please wear clothing on the day of your clinic that lets this area be easily accessible.

Depending on insurance carrier, claims may be filed as Staying Healthy Medical Services or Community Health and Immunization Services.

**A copy of your driver's license is needed to file your insurance claim and if paying by check. Your actual driver's license number is not used and can be marked out on your photocopy if you prefer. All other information must be legible on the copy.

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Need help? Contact us at info@stayinghealthymedical.com.


Passport Health is committed to keeping your personal data safe and we take every reasonable precaution to ensure security. Access to your personal information is restricted to employees at Passport Health. Your personal data is used for internal purposes only and is never sold or shared with anyone outside of Passport Health.