Cancel or Reschedule My Vaccine Appointment
Plans change — no problem! Complete this quick form to cancel or reschedule your upcoming vaccine appointment with Skippack Pharmacy. Want to reschedule? Include your preferred new date and time in the comments section below, and our team will take care of changing your appointment for you. You do not need to schedule another appointment online. Just need to cancel? If you do not provide a new date and time, we’ll cancel your current appointment. Whenever you’re ready, you can schedule a new appointment at SkippackPharmacy.com/Immunizations. Please note: Submitting this form does not update your appointment immediately. Our team will process your request shortly. If you receive an automated reminder for your original appointment in the meantime, you can disregard it.
Patient Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Patient #2 Name — Optional
First Name
Last Name
Patient #3 Name — Optional
First Name
Last Name
Patient #4 Name — Optional
First Name
Last Name
What Date Was Your Appointment For?
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Which vaccine(s) were you scheduled to receive? Select all that apply.
*
COVID-19
Flu
RSV
Pneumonia
Shingles
Tdap / Tetanus
Hepatitis A
Hepatitis B
Hepatitis A & B
HPV
MMR
Chickenpox / Varicella
Meningitis
Polio
Typhoid / Travel Vaccine
Other / Not Sure
Why are you cancelling?
*
I need a different date or time
I am not feeling well
I received my vaccine elsewhere
I already received this vaccine
I no longer need/want the vaccine
I accidentally booked a duplicate appointment
Other
Other
Anything else you'd like our team to know? (if rescheduling, new date & time you'd like the appointment(s) for
Submit
Should be Empty: