• Moderna COVID-19 Vaccine Consent Form

    18 years and older
  • This form is for Moderna Bivalent (Omicron) vaccinations.

    The CDC has recently simplified the COVID-19 Vaccination recommendations.

    If you are unvaccinated, use this form to schedule your one dose series.

    If you are vaccinated with NO Bivalent/Omicron booster, use this form to schedule your booster.

    If you are over 65 and HAD a Bivalent/Omicron booster, use this form to schedule a second booster if it has been more than 4 months since your last vaccination.

     

  • **Disclaimer**  If there are no time slots available, we have no vaccine.  Please do not call the store and just check back later for future availability.  Thank you!

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