Protect your employees from the flu: order form

If you are not a Mensura client, please complete the form below untill 29 September to order your flu vaccines. We will contact you to fix a suitable vaccination date and time.

If you are already a customer, you can order your vaccines via the client zone.

The fields with an * must be completed.

About your organisation

Invoice address (if that differs from the address above)

Number of vaccines

While stocks last. If stocks have been depleted, Mensura will inform you via phone.

At which location do you want to vaccinate your employees?

1I choose to vaccinate at our establishment (minimum 20 vaccines).

2. I choose to vaccinate at a Mensura consultation centre (minimum 1 vaccine).

Confirmation

 

Check the box confirming you are not a robot. That way we know your registration is not spam.