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COVID-19 Vaccine Appointment - Jonesboro
COVID-19 Vaccine Appointment - Jonesboro
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COVID-19 Vaccine Appointment - Jonesboro
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  • English (US)
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    Southern Pharmacy, in coordination with the Arkansas Department of Health, will be a participating COVID-19 vaccine provider. Vaccine distribution will follow the Arkansas Department of Health Vaccination Plan Map. The Arkansas Department of Health Vaccination Plan Map can be viewed here. 

    All Arkansans greater than 12 years of age are eligible to receive COVID-19 vaccines

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    COVID-19 Third Doses

    The CDC Advisory Committe on Immunizations (ACIP) has recommended COVID-19 vaccine third doses for Moderately to Severely Immunocompromised People

    CDC guidelines regarding COVID-19 vaccine third doses can be viewed here:

    https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html

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    COVID-19 Booster Doses

    CDC recommends that the following groups should receive a booster shot of Pfizer-BioNTech’s COVID-19 Vaccine at least 6 months after completing their Pfizer-BioNTech primary series (i.e., the first 2 doses of a COVID-19 vaccine):

    • people aged 65 years and older
    • residents aged 18 years and older in long-term care settings
    • people aged 50–64 years with underlying medical conditions

    CDC also recommends that the following groups may receive a booster shot of Pfizer-BioNTech’s COVID-19 Vaccine at least 6 months after completing their Pfizer-BioNTech primary series, based on their individual benefits and risks:

    • people aged 18–49 years with underlying medical conditions
    • people aged 18–64 years at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting

    CDC guidelines regarding COVID-19 vaccine booster doses can be viewed here:

    https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html

    Please complete the COVID-19 Vaccine Appointment Request to schedule a COVID-19 vaccination

    CLICK NEXT TO CONTINUE

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    Southern Pharmacy

    COVID-19 Vaccination Appointment

    Monday - Friday

    10pm - 4pm

    Location

    3001 Apache Drive

    Jonesboro

     

    CLICK NEXT TO CONTINUE

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    CDC guidelines for COVID-19 vaccine third doses can be viewed here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html. CDC guidelines for COVID-19 vaccine booster doses can be viewed here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html. Underlying medical conditions can be viewed here: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html
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    Email will be used to confirm appointment time. NOT REQUIRED.
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    Please select a Test Appointment Time
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    RELEASE AND ASSIGNMENT:

    ·  I have read or had explained to me the Vaccine Recipient Emergency Use Authorization (EUA) Fact Sheet for COVID-19 vaccine risks and benefits. To read the Vaccine Recipient Emergency Use Authorization Fact Sheet for each vaccine visit the website https://www.cdc.gov/vaccines/covid-19/eua/index.html to view current EUA: or you may also visit the Local Health Unit or private provider to receive a printed copy of the EUA Fact Sheet.

    ·  I give consent to this COVID-19 provider/staff for the individual named above to be vaccinated with COVID-19 vaccine.

    ·  I hereby acknowledge that I have reviewed a copy of the Provider’s Privacy Notice.

    ·  I understand that information about this COVID-19 vaccination will be included in (WebIZ) Arkansas Immunization Information System. 

    TO MY INSURANCE CARRIERS:

    ·  I authorize the release of any medical information necessary to process my insurance claim(s).

    ·  I authorize and request payment of medical benefits directly to this COVID-19 Provider.

    ·  I agree that the authorization will cover all medical services rendered until I revoke the authorization.

    ·  I agree that the photocopy of this form may be used instead of the original.

     

    CONSENT TO NOTIFY:

     I consent that Southern Pharmacy may contact me via email and/or sms message using the information provided.  Contact information may include COVID-19 vaccine availability, COVID-19 vaccine appointment reminders, and other healthcare information. 

    View the Southern Pharmacy privacy policy here

    PLEASE CLICK SUBMIT TO VERIFY CONSENT

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