Providence Flu 22/23

Which Flu vaccine do you need? *
Due to high demand, we have run out of the High-Dose for ages 65 and up and will not be receiving any more this flu season. If you are over the age of 65 and would like to get a regular flu shot, please re-select regular on the drop-down above.

If you would like a high-dose shot please check with your provider or other pharmacies around town to see if they have any high-dose available.

We apologize for the inconvenience.
Select Appointment Date/Time*
Calculation for Appointment Date/Time
Name*

First Name Last Name
Date of Birth *

MonthDay Year
Date
Sex*
Phone Number*
Street Address*
City*
State*
Zip*
Email for appointment confirmation
example@example.com
Date

MonthDay Year
Date
Do you have insurance? *
If you have private/commercial insurance please make sure your card has prescription coverage information on it (this will include numbers like Rx Bin)

If you are covered under Medicare please bring your red-white-and blue card that has your Medicare number on it.

If you are covered under Medicaid your card should have your DCN number on it.
If you are uninsured there is a cost for the Flu Shot.

The regular flu shot is $30

The high-dose (for ages 65+) is $85
Directions
Quantity
Should be Empty: