• Plumsted Pharmacy Paxlovid Screening

    This is a screening form for Paxlovid (COVID-19 Therapeutics). A pharmacist will review this information to determine if treatment is appropriate. Please upload all necessary information in this form. If you have any questions/concerns please call 609-758-8829. If you are unable to find an appointment time that works for you please call the number above to see if we have emergency appointments available. There is a charge of $50 for a Paxlovid Screening Appointment, this cost is included with a RAPID COVID-19 test option. Currently we are unable to accept insurance for screening appointments, however if Paxlovid is prescribed by our pharmacist, there will be no cost for the medication itself.
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  • If you have a primary care doctor please provide their information.
    Primary Care doctor's name      
    Primary Care doctor's phone              

  • Health Screening Questionnaire

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  • We will reach out to your doctor to determine your kidney and liver function as required by Paxlovid prescribing authorization.
    Primary Care doctor's name      
    Primary care doctor's phone         

  • Based on your medical history provided please contact your primary care doctor for advanced screening for Paxlovid.

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        Paxlovid Screening and Consult with Pharmacist
        $50.00
          
        Rapid COVID-19 Test and Paxlovid Screening with Pharmacist Results in Approximately 15 minutes
        $100.00
          
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