Director: Steve Williams, RN • Phone: (260) 449-7514 • FAX: (260) 449-3996 • Email:
Location: 4813 New Haven Ave., Fort Wayne, IN 46803 • Hours: 8 a.m. to Noon and 1 to 4 p.m., Monday - Friday
Meet the Staff: Lucinda Cress, RN; Jenifer Swanson, LPN: Tamar Brewer, MA; Laura Fair, Administrative Asst.; Lindsay Horace, Administrative Asst.


Health History Forms
If you are planning to visit our clinic, you can save some time by filling out this health history form for you or your child.

Health History Form

Authorization Form
If someone other than the parent or legal guardian is bringing the child to our Immunization Clinic, the parent must sign the form below and attach a copy of his/her driver's license.

Authorization to consent to medical treatment for minor child of adult non-parent

Vaccines for Children

The Immunization Clinic administers the following vaccines to children through 18 years of age:

  • DTaP - diptheria, pertussis, acellular pertussis
  • Td or Tdap- tetanus, diptheria or tetanus, diptheria, pertussis
  • Hib - human influenza type B
  • Varicella - chicken pox
  • IPV - injectable polio vaccine
  • MMR - measles, mumps, rubella
  • HEP B - hepatitis B
  • HEP A - hepatitis A
  • MCV4 - meningococcal
  • PCV7- pneumococcal conjugate
  • Rota TeqTM - rotavirus
  • Influenza - flu (seasonal)
  • HPV (Gardasil or Cervarix) - genital human papillomarivus

Due to an unpredictable vaccine supply, not all vaccines are available at all times for children.  Please call (260) 449-7514 for more information.

There is an $9 adminiistration fee per vaccine. Starting July 1, 2011, patients who have insurance that pays for vaccines will also have to pay the cost of the vaccine. When making an appointment, the approximate costs will be given.

Vaccine Price Sheet

Vaccines for Adults

The Immunization Clinic offers the following vaccines to adults:

  • Tdap- tetanus, diptheria or tetanus, diptheria, pertussis

Please ask about pricing when you make your appointment as prices do change.

Super Shot

Super Shot Inc. also provides immunizations to children and adolescents in Allen County at various locations throughout the community. Super Shot charges a minimal fee of $8 per shot. Medicaid is accepted and no one is turned away for inability to pay. Super Shot is not a government program and is not affiliated with the Department of Health.

General Immunization Information

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Did You Know?

The word “measles” comes from the Latin word meaning “miserable".