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  • COVID-19 Immunization Scheduling and Questionnaire

  • Due to limited vaccine supply, we are prioritizing patients over the age of 65, those with significant medical conditions, and essential workers. If you are 65+, OR if you are younger, but have a significant medical condition, please fill out the following form. If you do NOT meet these qualifications please check back in a few days, as the State of Minnesota will be eventually loosening these restrictions. Thanks you for your patience.

  • Your Information

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  • Health Questionnaire

  • Have you ever had an allergic reaction to:

    This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen or that caused you to go the hospital. It would also include an allergic reaction that occurred within 4 hours that cause hives, swelling or respiratory distress including wheezing.
  • Please call Iverson Corner Drug at 218-333-4000 or your healthcare provider. Please do NOT continue past this point, the system will not allow you to schedule an appointment.

  • Insurance Information

    The cost of the vaccine will either be covered by your insurance or the federal government. Please provide the necessary information to make sure the vaccine is covered for you.
  • The federal government is covering the cost of the vaccine for patients without insurance. We will need your social security number or driver's license.

  • Schedule an Appointment

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