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Refill an Rx
STOPPING IN FOR A VACCINE?
FILL OUT THE VACCINATION CONSENT FORM BEFORE YOUR APPOINTMENT
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Vaccine Consent Form
First name
Last name
Select an Address
Email
Select the vaccine or vaccinations desired from the list below:
Flu
COVID
RSV
Pneumonia
Shingles
TdaP
If you plan to receive this vaccination at an off-site clinic (i.e. local school or business), please note the date, time and location below:
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