Appointment
Vaccinations
Flu
Flu 65+
COVID-19 (Moderna; >65 years of age OR 6 months to 64 years of age who are at high risk for severe COVID-19))
RSV (>75 years of age OR 50 to 74 years of age with increased risk of RSV. Only a single dose is recommended)
Pneumonia
Name
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Date of Birth
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Month
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Day
Year
Date
Age
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Gender
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Male
Female
Address
Address
Street Address Line 2
City
State
ZIP
Phone Number
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Medicare ID Number - Please bring your Medicare card with you to the appointment.
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