Travel Consult and Yellow Fever Vaccine Appointments

Travel Consult and Yellow Fever Vaccine Appointments

Yellow Fever vaccines are required or strongly recommended for travel to certain countries. Let Tarrytown Pharmacy provide your vaccination and required yellow fever travel consult! We also offer general travel consultations for those who aren't sure what vaccines they may need before a big trip!
My Products - Select Number of Patients Needing Consult (Groups can be seen in the same appointment time, and there is a discounted charge per patient)*
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Yellow Fever Vaccine Appointment - Required ConsultA consultation is required to receive a Yellow Fever Vaccine. A Tarrytown Pharmacy pharmacist will provide a custom travel consultation in regards to updates, recommended immunizations, and answer any questions you have. The yellow fever vaccine and any others you would like to receive will be given at this time.
$49.99 Quantity

Travel Consultation (15 minutes)Have a Tarrytown Pharmacy pharmacist provide information concerning travel updates, required and recommended immunizations, and answer any other questions you might have. The vaccinations requested will be given at this time.
$49.99 Quantity

Total

$0.00
Why is a pre-travel consultation required?
- The CDC requires a "Pre-Travel Consultation" for people receiving the Yellow Fever Vaccine
- You will get a lot of helpful and important information regarding your travels and recommended vaccinations.
- The Yellow Fever Vaccine total cost is $330
  - If you have insurance, we process prescription insurance to see if they will help cover some or all of the cost.
  - Uninsured or cash-pay patients are welcome
- The cost of this consult is not refundable if you cancel the appointment.
  - For families that just need one consultation, you can indicate that in the form below. You will just be charged for one consultation fee, but will still be responsible for any costs associated with the vaccine.
Appointment Scheduling

If you don't see a date or time that works for you, we can work with you to get you taken care of on your schedule. Feel free to call us with any scheduling questions 512-478-6419.
Yellow Fever Appointment*
Traveler Information and Demographics
Please indicate how many people are needing a vaccine/consultation:*

One PatientMore than one patient
Traveling Patient Name:*

First NameLast Name

Primary Contact for Group*

First NameLast Name
Contact Phone Number*
Please enter a valid phone number.
Traveling Patient Date of Birth:*

MonthDayYear
Date
Traveling Patient Email:*
example@example.com
Cell Phone Number:*
Please enter a valid phone number.
Traveling Patient Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please upload a photo of your prescription and medical insurance cards: (if applicable)

Cancelof
Patient Sex:*

MaleFemale

Where will you be traveling? (Please list countries and cities)*
Please select your reason for traveling:*

BusinessLeisureVolunteeringOther
What areas will you be staying in?*

Rural (More remote areas)Urban (Bigger cities)Other
What date will you be leaving for your trip?*

MonthDayYear
Date
Do you know of any required immunizations that you need before traveling?*

YesNo
What required immunizations were you told you needed?*

Health Questionnaire:*

	Yes	No	I Don't Know
Do you have any chronic medical conditions? (kidney or liver disease, diabetes, etc)
Do you have any drug allergies?
Do you have a severe allergy to eggs?
Do you have any immunocompromising conditions?
Do you expect to come in contact with animals on your travels?
Have you traveled internationally before?

Please tell us any other information you'd like us to know, or questions you would like us to help answer:
How did you hear about our travel services?
Please bring a copy of your vaccine records, or immunization card to you appointment, if you have that available. Thank you!

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

	Indicate Patient Needing Vaccine/Consult (Yes/No)	Patient Name:	Date of Birth: (mm/dd/yyy)	Patient Gender:	Patient Address:	Patient Cell Phone #:	Patient Email:
Patient 1
Patient 2
Patient 3
Patient 4
Patient 5
Patient 6

Travel Consult and Yellow Fever Vaccine Appointments

Appointment Scheduling

Traveler Information and Demographics