Vaccine appointment scheduling
(for all vaccine appointments at WinnMed Pharmacy)
Full Name
*
First Name
Last Name
Date of birth
*
-
Month
-
Day
Year
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please pick a date and time for your vaccine appointment:
*
Please write your appointment date and time down
;
no reminder message is able to be sent.
Which vaccine(s) are you scheduling your appointment for? (select up to 2 max)
*
Tetanus booster
RSV vaccine (given once only; ages 50-74 at high risk, and everyone 75 yoa+)
Shingles (Shingrix)
Pneumonia vaccine
Please select which arm (R, L, or one in each arm) you want to get the vaccine in?
*
Right arm
Left arm
One in each arm
Submit
Should be Empty: