THIS IS FOR OUR WAITING LIST ONLY. THIS IS NOT AN APPOINTMENT. PLEASE CONTINUE TO MAKE AN APPOINTMENT AT ANY AVAILABLE SITE. THIS LIST IS ONLY BEING USED TO HELP USE UP ANY EXTRA DOSES WE MAY HAVE.
Please note at this time we can only vaccinate people 65 and older. No other groups. Thank you
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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