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  • Location: 1015 Budapest, Hattyú utca 14, 5th floor, Hattyúház
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Call Us: +36-1-224-9090
Leading English-speaking Clinic in Budapest
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Flu Vaccination Request

We will contact you shortly after your completion of this form to schedule your appointment for the flu shot.

Name(Required)
YYYY dash MM dash DD
Are you currently a FirstMed Premium Plan holder?(Required)
Have you ever been a patient in FirstMed?(Required)
Can we find you as a previously registered patient?
Name of second patient(Required)
YYYY dash MM dash DD
Does this patient have a Premium Plan?(Required)
Has this person been a patient in FirstMed at any time?(Required)
Can we find them as a previously registered patient?
Name of third patient(Required)
YYYY dash MM dash DD
Does this patient have a Premium Plan?(Required)
Has this person been a patient in FirstMed at any time?(Required)
Can we find them as a previously registered patient?
Name of fourth patient(Required)
YYYY dash MM dash DD
Does this patient have a Premium Plan?(Required)
Has this person been a patient in FirstMed at any time?(Required)
Can we find them as a previously registered patient?
Name of fifth patient(Required)
YYYY dash MM dash DD
Does this patient have a Premium Plan?(Required)
Has this person been a patient in FirstMed at any time?(Required)
Can we find them as a previously registered patient?
Do you (or anyone in your group) have any of the following risk factors?(Required)
If you check yes to having any of these risk factors we won't be able to vaccinate you.
Are you (or is anyone in your group) currently:(Required)
If you check yes to any of these you will need to speak to a doctor before your vaccination.
Have you received, or are you expecting to receive, any vaccination in the last/next two weeks (including any type of COVID vaccination)?(Required)
Consent(Required)
I hereby confirm for on behalf of everyone in my party that the side-effects and possible complications of the sesonal flu vaccination have been clearly explained and I/we fully understand them. At the same time I accept the contents detailed in the statement of the Country Medical Officer:
1. In accordance with the relevant legal guidance, the compensation for the complications of the non-mandatory vaccinations is born by the manufacturer of the vaccine.
2. If the physician gives the vaccination in accordance with the relevant medical guidelines, he/she will not be responsible for any complications nor will be FirstMed-FMC Kft.
3. If I or anyone in my party becomes ill or develops a fever before or on the day of the vaccination, I will notify FirstMed and might be subject to rescheduling
4. By signing this declaration, I agree on behalf of the entire party that the vaccination will be given at my/our own risk and that FirstMed-FMC Kft. takes no legal, financial and moral responsibilities for the vaccination administration, the vaccination itself or any potential side effects.
Consent(Required)
I hereby confirm that the side-effects and possible complications of the sesonal flu vaccination have been clearly explained to me and I fully understand them. At the same time I accept the contents detailed in the statement of the Country Medical Officer:
1. In accordance with the relevant legal guidance, the compensation for the complications of the non-mandatory vaccinations is born by the manufacturer of the vaccine.
2. If the physician gives the vaccination in accordance with the relevant medical guidelines, he/she will not be responsible for any complications nor will be FirstMed-FMC Kft.
3. If I become ill or develop a fever before or on the day of the vaccination, I will notify FirstMed and might be subject to rescheduling
4. By signing this declaration, I agree that the vaccination will be given at my own risk and that FirstMed-FMC Kft. takes no legal, financial and moral responsibilities for the vaccination administration, the vaccination itself or any potential side effects.

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Location

1015 Budapest, District I.
Hattyú utca 14, 5th floor,
Hattyúház

We are located close to Széll Kálmán tér and the Mammut shopping center. The clinic is easily accessible by car, tram, or metro.

Clinic Hours

Mon-Fri: 8:00 am to 8:00 pm
Weekends: 9:00 am to 3:00 pm
No walk-ins, please call first!

After hours: On-call doctors available, please call ahead!

To schedule an appointment please call our main number
+36-1-224-9090

Blog

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  • little premature newborn infant childIt’s World Prematurity Day!2022-11-17 - 13:35
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