Cancel My Vaccine Appointment
We understand things may come up or you might not be feeling well & that you would like to cancel your vaccine appointment. We appreciate you informing us and requesting to cancel that appointment, making room for someone else to take that vaccine appointment slot. When you would like to reschedule, please go back onto our website and sign up for a NEW appointment just the way you had signed up for this appointment (unfortunately, our system does not have an option to let you reschedule without filling your information in again) BUT you can select the option that says you have received vaccines through Skippack Pharmacy before so you don't have to upload your insurance cards. Please note, filling this out does not automatically cancel your appointment in our system right away, our team will take care of the cancellation but you may still get an automated vaccine appointment reminder (please ignore that). ***FILL ONE OF THESE OUT FOR EACH PERSON YOU ARE CANCELLING AN APPOINTMENT FOR***
Patient Name
*
First Name
Last Name
What Date Was Your Appointment For?
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Month
-
Day
Year
Date
Which Vaccine(s) Did You Have an Appointment For That You'd Like to Cancel?
*
COVID-19, Moderna 12+
COVID-19, Pfizer 12+
COVID-19, Moderna 6mo-11yrs
COVID-19 Pfizer 5-11yrs
COVID-19, Pfizer 6mo-4yrs
COVID-19, Novavax
Flu, FLUCELVAX, 3-64
Flu, FLUAD, 65+
RSV (Respiratory Synctial Virus), AREXVY, 60+
RSV (Respiratory Synctial Virus), ABRYSVO, Pregnant
Shingles, SHINGRIX, 1st Dose, 50+
Shingles, SHINGRIX, 2nd Dose, 50+, 2-6 months after 1st dose
Pneumonia, PREVNAR 20, 65+ or 19-64 (Immunocompromised)
Pneumonia, PNEUMOVAX, 65+ or 19-64 (Immunocompromised)
Hepatitis B, ENGERIX B, 1st Dose, 18+
Hepatitis B, ENGERIX B, 2nd Dose (1 month after 1st dose)
Hepatitis B, ENGERIX B, 3rd Dose (6 months after 2nd dose)
Hepatitis A & B, TWINRIX, 18+
Typhoid, TYPHIM, Age 18+ (at least 2 weeks prior to expected exposure)
Boostrix (Tdap - Whooping Cough), 18+
What is the Reason for Cancellation?
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I or a family member contracted COVID-19 or are not feeling well.
Something came up and I can no longer make it.
I received my vaccine elsewhere.
I no longer want to receive the vaccine.
I cannot make it - I will reschedule later.
I booked a duplicate appointment.
I already received my vaccine through you.
Other
Submit
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