• Visit Us: 601 S Main Whitewater, KS 67154
  • Questions? We’re here to help! (316) 799-2181
Wheat State Manor
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Forms

VIS Influenza Sheet

VIS Pneumococcal Conjugate Vaccine

VIS Pneumococcal Polysaccharide Vaccine

Pneumococcal Vaccination Consent and Declincation Form

Influenza Vaccination and Declination Consent Form

AuBurn Pharmacy COVID-19 Vaccination Consent Form

COVID-19 Vaccine Information Fact Sheet

COVID-19 Vaccine Declination Form

Staff COVID Vaccination Religious Exemption

Staff COVID-19 Medical Exemption Form

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© 2023 Wheat State Manor. All Rights Reserved. Website Powered by Wichita Designs.

  • About Us
    • Careers
      • Employment Application
    • Forms
    • Donate Online
  • Quality of Care
  • Quality of Life
  • Payments
  • Contact Us
  •  
  • Call: (316) 799-2181
  • Visit Us: 601 S Main Whitewater, KS 67154
  • Questions? We’re here to help! (316) 799-2181