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  • 美福藥局疫苗接種注册平台

    美福祝願您和您的家人平安健康
  • 秋冬季疫苗問與答

  • 讓我們進一步瞭解您的情況

    我們希望盡可能幫您節省在場的等待時間,因此現在請您提前填寫您的個人資訊。 所有带有 * 問題均為必填項。此注册平台获得美国健康隐私法认证,您的个人信息完全收到保护。
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  • 請選擇您的疫苗

    所有欄位均為必填項。
  • 有任何疑問或需要幫助,請致電281-506-2453美福藥房,我們的工作人員會協助您選擇適合您接種的疫苗。

  • 請提供處方葯保險詳情

    如果您有奥巴馬保險或者Medicare保險,您需要攜帶您的保險卡前來接種疫苗。 除非標記為可選,所有問題均為必填項。
  • 請參閱您的Medicare紅藍卡,並提供您的紅藍卡的正面照片。您的紅藍卡號碼由11個隨機生成的數位和字母組成(請參閱下面的示例)。

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  • 請參閱您的處方葯保險卡,並提供您的卡的正面和背面照片。處方葯保險卡包含會員的ID號、Rx Bin、Rx Group 和 Rx PCN 資訊(請參閱下面的示例)。

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  • Consent to contact you (同意美福药局用您提供的信息与您联络)

  • By providing your mobile number and/or e-mail address, you consent to receive live and automated calls, text messages and/or e-mails about this and follow-up visits, your account, and important health care messages including additional vaccine scheduling and a copy of your immunization record. These messages may include other PHI related to the vaccine sent by unencrypted messages.

    Under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), RXSIM dba Medx Pharmacy is required to maintain the privacy of your personal health information (PHI), and provide you with a Notice of Privacy Practices that describes how we may use your information for treatment, payment, and other purposes that details your rights regarding the privacy of your health and medical information. If you have any questions about this Notice, please contact RXSIM dba Medx Pharmacy 281-506-2453.

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