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.

1

FILL OUT THE REQUEST FORM

Fill out the Vaccine Request Form in its entirety.

2

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.

3

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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