Appointment Reminder Page

Thank you for scheduling your appointment for immunizations.  Please read the following so we can best serve you.

For the Health and Safety of our clients and employees, new efforts have been put in place for immunization appointments which include: 

A prescreening and educational phone call 
Please have enclosed form COMPLETED UPON ARRIVAL
Only one parent/guardian should accompany a child per appointment
Adults and children over 24 months should also wear a mask or face covering.
Please bring insurance cards, shots records and guardianship paperwork if applicable.

Any effort not followed may result in rescheduling the appointment.

Thank you for your cooperation during this time!

ACHD- Nursing Division Staff

 What should I bring with me to each appointment?

  1. Please bring all past immunization records and all insurance cards*.
  2. If you have printing capability, please bring the following 2 page form COMPLETED:
  • Forms are located in the Right hand column under Resources: Forms & PDF's section
    • Appropriate Vaccine Form: Pediatric (0 to 18 years old) Adults (19 years and older).
    • Parental Permission Form if someone other than a parent / guardian accompanies a child younger than 18 years old to an appointment.

  3. If applicable, bring guardianship/custody papers TO EACH VISIT

 *How do I know if my insurance company will cover my visit?

The Auglaize County Health Department accepts Medicaid and is contracted with most commercial health insurance companies. For commercial health insurance, please call the Member Services phone number on the back of your insurance card to:

  • Verify coverage services at our facility including deductible.
  • To help with verification, you may provide your health insurance company our NPI # 1801959630.

While we are contracted with Medical Mutual, we have been informed that Mercy Health/SRMC will only cover services provided by one of their locations/providers – therefore not covered at our facility.

For your convenience, we offer a discounted cash day of service fee.