WAITING LIST ONLY. This is not for an actual appointment!
Please only enter your information if you are a 50 or older, a teacher or have one of the qualified conditions as described by NY State.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
What town do you live in.
*
If you are called for this appointment it will be short notice. How long would you need to get ready and be at our store
*
Can be there within 20 minutes
Can be there within 45 minutes
It will take me up to 1 hour
It will likely take more than 1 hour
Submit
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