Medical Service Request rev20231206 Patient Name(Required) First Last Parent/Guardian Name (If patient is under 18 years old) First Last Phone(Required)Email What school does your child attend?(Required) Not Applicable Catherine Kolnaski Magnet School Ella T. Grasso Technical School Gales Ferry School/Juliet W. Long School Gallub Hill School Groton Middle School Fitch Senior High School Ledyard Middle School Ledyard High School Mystic River Magnet School Thames River Magnet School Bennie Dover Jackson Middle School Jennings Elementary School Nathan Hale Elementary School New London High School Regional Multicultural Magnet School Winthrop Elementary School Stonington Middle School The Friendship School Harbor Elementary School Barnum Elementary School Northeast Academy Elementary School Stonington High School West Vine Street School Other Services requested(check all applicable) Physical Flu vaccination Other vaccination Other service Disclaimer: We are currently receiving a high volume of requests for services. Please expect return contact for scheduling in 2-3 days. For urgent or emergent requests please call 911, or go to the nearest emergency department for assistance.
