Dispill - Personalized Blister Packaging
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Immunization Consultation / Travel Clinic
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COVID-19 Vaccine Registration
COVID-19 VACCINE REGISTRATION
Please follow the steps below to request a COVID-19 Vaccine.
You have the choice of either the Moderna (2 dose series) or the Johnson & Johnson (single dose).
If you get the Moderna vaccine, we will reach out to you to schedule your second dose.
You are required to be 18 years of age or older to get the vaccine.
You must stay at the pharmacy for 15 minutes after your shot.
Please upload your prescription insurance information.
If you do not have insurance we need your ID, Driver's License or SSN.
For more information about the vaccine, click the links below.
Learn more about Moderna
Learn more about Johnson & Johnson
FILL OUT THE REQUEST FORM
Fill out the
Vaccine Request Form
in its entirety.
WAIT FOR A PHONE CALL FROM US
Once you fill out the above form, we will process your request and give you a call to schedule an appointment time.
RECEIVE YOUR COVID-19 VACCINE
Head to the pharmacy during your appointment time. The appointment should last 20-30 minutes (this includes the 15 minute observation time).
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