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  • Joseph Pharmacy 2ND(SECOND) Bivalent Covid-19 Vaccine Appointment Form

  • Requirements for Vaccination of 2ND(SECOND) Bivalent Booster Dose

  • At this time we are able to vaccinate 2ND(SECOND) BIVALENT Booster shots for Covid-19 for these populations only: 

     

    Those 65 YEARS OF AGE AND OLDER WHO HAVE HAD A BIVALENT COVID 19 VACCINE 4 MONTHS AGO OR LONGER

     

    OR

    THOSE MODERATELY OR SEVERELY IMMUNOCOMPROMISED WHO HAVE HAD A BIVALENT COVID-19 VACCINE 2 MONTHS AGO OR LONGER

     

    *** An email address will be used to confirm your appointment. In the unlikely event that you are not on our appoinment list, we will ask you for your confirmation email as proof of registration. Those without proof may be asked to schedule an appointment for a later date.

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  • Questionnaire

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    For the next section, if you have the RED WHITE AND BLUE Medicare card, we want that instead.
  • By signing below, I'm attesting that I meet the criteria for a 2nd Bivalent Covid-19 vaccine, that is:

     

    Those 65 YEARS OF AGE AND OLDER WHO HAVE HAD A BIVALENT COVID 19 VACCINE 4 MONTHS AGO OR LONGER

     

    OR

    THOSE MODERATELY OR SEVERELY IMMUNOCOMPROMISED WHO HAVE HAD A BIVALENT COVID-19 VACCINE 2 MONTHS AGO OR LONGER

     

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