• Pfizer COVID-19 Immunization Scheduling Form

    PLEASE BRING YOUR VACCINE CARD, INSURANCE CARDS AND ID TO YOUR APPOINTMENT. This form is ONLY for those age 12 and older. If you are in need of the Pfizer for age 5-11, please see other scheduling link on Donlonrx.com
  • People are considered to be moderately or severely immunocompromised (have a weakened immune system) due to several types of conditions and treatments. Examples include:

    -Been receiving active cancer treatment for tumors or cancers of the blood
    -Received an organ transplant and are taking medicine to suppress the immune system
    -Received chimeric antigen receptor (CAR)-T-cell therapy (a treatment to help your immune system attach to and kill cancer cells) or received a stem cell transplant (within the last 2 years)
    -Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
    -Advanced or untreated HIV infection
    -Active treatment with high-dose corticosteroids or other drugs that may suppress their immune response

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  • COVID-19 Vaccination Appointment

    Please keep your appointment or call the pharmacy if you need to cancel or change it.
  • ***PLEASE NOTE*** 

    If you are scheduling your FIRST dose, your appointment for your SECOND dose will be scheduled three weeks following your first dose. 

     

    Please bring along an ID as well as all your insurance cards and COVID vaccine card. Thank you!

  • Patient Information

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