Because of the reasons stated above, I, the undersigned, request that my CDC COVID-19 Vaccine card be changed. I acknowledge that the relevant health information contained on the replacement card belongs to me and that I received the dose(s) indicated on the card. I promise that I will not use this replacement card for any purpose other than to provide confirmation of immunization receipt.
I agree the payment of The vaccine replacement card is non-refundable once submited.