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Department of Health
V8.4.0 10/06/2026 1:30 PM

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Welcome to CDMS Kiosk Registration V8.4.0 10/06/2026 1:30 PM

Please click on the REGISTER NOW button to start your registration for

George Fischer Middle School Flu Clinic 10/21/26

George Fischer Middle School
281 Fair St
Carmel, NY 10512

October 21, 2026

Prescreen
Confirm

Prescreen
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Screening Questions

On the day of the appointment, will the vaccine recipient be less than 6 months of age?

	Yes
	No
	Unknown

On the day of the appointment, will the vaccine recipient be at least 6 months old and less than 36 months old?

	Yes
	No
	Unknown

On the day of the appointment, will the vaccine recipient be at least 6 months old and less than 9 years old?

	Yes
	No
	Unknown

On the day of your appointment, will it have been at least 28 days since your last flu vaccine?

	Yes
	No
	Unknown

Are you currently pregnant, think you might be pregnant, or considering becoming pregnant in the next month (30 days)?

	Yes
	No
	Unknown

Are you feeling sick today with or without fever?

	Yes
	No
	Unknown

Have you ever had Guillain-Barre Syndrome?

	Yes
	No
	Unknown

Guillain-Barre syndrome is a serious condition of the nervous system.

Have you ever had a severe reaction after receiving any vaccine or do you have any severe, life-threatening allergies?

	Yes
	No
	Unknown

This does not include minor skin reactions.

On the day of the appointment, will the vaccine recipient be 65 years of age or older?

	Yes
	No
	Unknown

Have you read or had read to you the Vaccine Information Statement for the Influenza (Flu) Vaccine (Inactivated or Recombinant) (Click to View)

	Yes
	No
	Unknown

Do you understand the risks and benefits of the vaccine and consent to receiving the Influenza (Flu) Vaccine (Inactivated or Recombinant)?

	Yes
	No
	Unknown

If you are 19 or older: Do you consent to release your immunization record to NYSIIS where it will be available to your healthcare provider?

	Yes
	No
	Unknown

NYSIIS is the New York State system that makes your vaccine related records available to your healthcare provider.

Instructions

An answer must be selected before you can proceed.

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After reviewing your answer to the screening questions,

You are Almost Done !

After reviewing your answers to the screening questions,

I will attend the Event.
I acknowledge that I have read guidance and plan to continue with the registration.

I will NOT attend the Event
and do not plan to continue with the registration.

Note: "Please select at least one option to proceed."

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