ALL 3 STEPS must be completed prior to your appointment. You will need to bring all consent forms along with your government issued photo ID, (If Available) Bring any Medical Insurance Card or Medicare Card (red, white, blue)
Complete the form to be placed on our appointment call list.
Please print this form and complete all applicable fields.
This is an online form that must be completed before your appointment. Please print, screenshot or email yourself the confirmation as proof for your appointment.
Pharmacies are only allowed to vaccinate New York State Residents 18+ for Moderna and Janssen Vaccines