Register for a COVID-19 Vaccine 1st Dose Age – 12+
We are committed to delivering as many COVID-19 vaccines as soon as possible. We are encouraged by the community interest in receiving the vaccine, which is a critical step in controlling the pandemic and saving lives.
IF no form is present then you can not sign up. Each individual will need to submit their own form in order to be registered and contacted as vaccine becomes available.
Please Note: If you have limited access to online services or technology, or you need assistance in registering, you can email firstname.lastname@example.org
Once you submit the form, you will receive additional communication via email
Once you submit your form, you will receive a confirmation email to the address you provided (be sure to verify E-mail), as well as second dose information. You can also access answers to “frequently asked questions” about the COVID-19 vaccine and the vaccine scheduling process.
· IF no form is present then we do not have any openings. Please check our website mid week to check availability. Please do not call the store for scheduling questions. THANK you in advance for your patience.
· Please bring ID and if applicable Medicare Part A/B red-white-blue card, along with confirmation email/printout.
Note: For Age below 16 please bring supporting document such as : birth certificate, passport or school ID
· Please DO NOT call, email or text. As any updates are posted on the website.
· Also, read the PA Department of Health Guidelines on the phases of Vaccine Distribution. Remember that you are required to complete the Vaccine Request Form.
· Click here to download Vaccine Recipient Fact Sheet
· Sample Vaccination Form: to be completed during booking