Pediatric Associates of Dallas
(Entrance is the 2nd floor of the parking ramp)
7859 Walnut Hl Ln #200, Dallas, TX 75230
Steps to register:
1. Complete this form for each person receiving a vaccination, and for each dose of vaccination you need. So a child receiving the Lil' Pfizer vaccination will need to complete this form three times, once for each dose in the series. The form serves as a consent to give each dose and this is a CDC requirement. It allows you to answer if there were any allergic reactions or concerns after each dose as well. We use the data from each clinic date chosen below to know how many of each vaccine to prepare the morning of the clinic. We appreciate the time it takes to do this, and apologize for the redundancy.
2. After submitting this form, you will be taken to a Sign Up Genius page to select a time slot on the day you registered for. This is a tool to help space clinic arrivals and minimize waiting times. Please select an open time slot. If you miss your time slot, you are fine, please come when you can.
If the Sign Up Genius is full on the date you registered for, simply skip this step. As a scheduling tool it has maximized its value. Arrive any time the clinic is open as we always vaccinate in the order of arrival. This process has worked well and wait times are very reasonable. So bottom line: do not change your registration date if the Sign Up Genius is full. We will have your vaccine ready to go.
As a reminder, Carpe Diem Health PLLC does not recieve your insurance information from Pediatric Associates of Dallas. Please take a moment and supply the information from your card below when your register.
There is no copay and nothing is billed to you / or due out of pocket for COVID19 vaccinations. Carpe Diem Health will bill your insurance for the shot administration fee.
If you do not have insurance at this time, please sign up for COVID vaccinations for you and your family at no cost. Simply leave the insurance boxes blank when you register your form(s).
3. You will receive an email after registering with the form information and your selected clinic date. You will receive a separate email from the Sign Up Genius software when/ if you choose a time slot.
4. You will receive a final email after your vaccination is complete, which will have a PDF attachment of your vaccine record for your files.
Vaccinations are registered with ImmTrac2, the Texas Immunization Registry.
Let us know if you have any feedback! We are always open to suggestions and ways to improve your experience.
Medical questions or concerns to:
or leave a voicemail or a text message to (972) 846-9550.
Vaccinations administered by Carpe Diem Health PLLC, a Texas COVID-19 vaccination provider.