Combined West and East Side Boys and Girls Club Childhood Vaccination Clinic Appointments

Brown County Public Health Childhood Vaccination Clinic Appointments

Vaccinations provided by Brown County Public Health at the East Side Boys and Girls Club (1451 University Ave, Green Bay, WI 54302) and the West Side Boys and Girls Club (311 S Oneida St, Green Bay, WI 54303).
Who can attend these vaccine clinics?

Brown County Public Health provides Vaccines for Children (VFC) program supplied vaccines. Please see below for eligibility.
- Children 18 years and younger AND (one of the following must apply):
  - Child does not have health insurance
  - Child is enrolled or eligible for Badgercare or Medicaid
  - Child is Native American or Alaska Native
  - Child has insurance that does not cover vaccines
Eligibility For VFC Clinic
Brown County Public Health Vaccine Eligibility

Child is 18 years old or younger and does not have health insuranceChild is 18 years old or younger and is enrolled or eligible for Badgercare or MedicaidChild is 18 years old or younger and is Native American or Alaska NativeChild is 18 years old or younger and has insurance that does not cover vaccinesNone of the above
Children whose health insurance covers the cost of vaccinations are not eligible to receive VFC Program vaccines. This also applies if an insurance carrier denies a claim to pay for the cost and administration of the vaccine because the plan's deductible had not been met.
Unfortunately, your child is not eligible for vaccines through Brown County Public Health. They may be able to get vaccines through their healthcare provider or local pharmacy. Check with your health insurance to see where vaccines are covered to make sure your child gets the vaccines they need. Thank you!
Child's Information (Child receiving vaccine)
If you have multiple children receiving vaccine, a new form will need to be completed for each child.
Child's Name*

First NameLast Name
Preferred Name/Pronouns
Child's Date of Birth*

MonthDayYear
Date
Parent/Guardian Contact Information

In case we need to reach you in regard to your child's vaccination appointment. If you are 18 and receiving vaccine, you can fill this section out with your information.
Parent/Guardian Name *

First NameLast Name
Parent/Guardian Phone Number *
Please enter a valid phone number.
Parent/Guardian Email (a confirmation email will be sent if provided)
example@example.com
Vaccines Needed
Do you know which vaccines your child needs or which vaccines you would like your child to receive?*

I do not know what vaccines my child needs- please determine at their appointmentI know which vaccines my child needs/I want them to receive (please select below)*
*Please note that nurses will check your child's vaccine records and recommend additional vaccines if they're missing any that are needed to stay healthy.
Additional Comment:
Vaccine(s) Requested (Please note we do use combination vaccines when able, so your child may not receive this number of vaccines)

Tetanus, Diphtheria, PertussisHib (Haemophilus influenzae type B)Hepatitis AHepatitis BHPV (human papilloma virus)InfluenzaMMR (measles, mumps, rubella)MeningitisMeningitis BPneumococcalPolioRotavirusVaricellaCOVID-19
Has your child received vaccines in Wisconsin?*

YesNoUnsure
If your child has never received vaccines in Wisconsin, we will need a copy of your child's vaccine record. This will help our nurses determine what vaccines your child needs. This record is needed a week prior to the day of clinic.

Cancelof
Appointments

Clinics switch between East and West Boys and Girls Club each month. A new form will need to be filled out for each appointment.
Please check DATE, TIME, and LOCATION when selecting appointment. If you do not get a confirmation email, please call us at 920-448-6400.

If there are no appointment times available, please call us at 920-448-6400.
East Side Boys and Girls Club- 1451 University Ave.*
West Side Boys and Girls Club- 311 S Oneida St*
Should be Empty:

Brown County Public Health Childhood Vaccination Clinic Appointments

Eligibility For VFC Clinic

Child's Information (Child receiving vaccine)

Parent/Guardian Contact Information

Vaccines Needed

Appointments