Flu Nurse booking request form

Please complete all of the sections below and submit your form to book. You may find it helpful to read our FAQ’s at the bottom of the page prior to completing the form.

If you have any questions or want to book for multiple sites please contact the flu team on 0345 6090 115^.

* indicates a mandatory field.

Company details

Main contact details

Invoice details

Bupa will contact you a day or two before your clinic to confirm the quantity of vaccines required.

Please confirm that all sites are suitable for the nurse and your employees on the day

The room should have:
• two chairs
• a small table
• a phone
• a waiting area with chairs outside
• JJ curtains or blinds on windows for privacy
• a large bin for waste paper

Flu vaccinations FAQs >

^ We may record or monitor our calls.

We recognise that when you give us personal information (which includes health information) you’re trusting us to take good care of it. Please see our privacy notice for more information about how we collect, use and protect your data.

If you don’t want to receive marketing about Bupa products and services that we think are relevant to you, please contact us at [email protected].

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