100 Glenns Creek Road
Frankfort, KY 40601
502- 564-7647
Monday – Friday 8:00am – 4:30pm


October 11, 2021
Dear Parent/Guardian:

The Franklin County Health Department will be providing Influenza vaccinations at the schools.
This year, the vaccine will, again protect against both Seasonal Influenza and H1N1 flu. There will be no cost to the parents for this vaccination. However, we will be billing insurance
companies this year.

Please complete the registration form  and return it to your
child’s homeroom teacher by Friday, October 15th; don’t forget to answer the Medical History questions and sign for consent.

Parents/Guardians are not required to be present when their child receives the vaccination if they have signed the consent form in advance.
We will only be administering injectable flu vaccine this year.

You may access the Influenza Vaccine Information Sheet and the Notice of Privacy Policy mentioned on the form, on our website, or you may request one from your child’s school.

Your child will receive their flu vaccine between October 18th and October 29th, 2021.

Remember this year we need your insurance information but there will be no co-pays.

If you have any questions or concerns, you may contact your school nurse.

Michelle Searcy, RN
Michelle Searcy, BSN, RN
School Nurse Supervisor

Vaccine Events at School

14th – Westridge Elementary School
15th – Collins Lane Elementary School
18th – Elkhorn Elementary School
19th – Early Learning Village School
20th – Elkhorn Middle School
21st – Bridgeport Elementary School
22nd – Peaks Mill elementary School
25th – Bondurant Middle School
26th – Franklin County High School
27th – Western Hills High School
28th Hearn Elementary School

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the Franklin County Health Department or the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation.

The completed AD-3027 form or letter must be submitted to USDA by:

1. Mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; or

2. Fax: (833) 256-1665 or (202) 690-7442; or

3. Email: [email protected]


The Franklin County Health Department is an EEO/EOP/AA/Title VI/Title IX/Section 504/ADA/ADEA institution in the provision of its education and employment programs and services. All qualified applicants will receive equal consideration for employment without regard to race, color, national origin, religion, sex (including gender identity and sexual orientation), pregnancy, marital status, sexual orientation, gender identity, age, physical or mental disability, genetic information, veteran status, and parental status.   

Franklin County Health Department - HIPAA Privacy and Disclosure Statement

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