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Online Appointment
Please remember to include your E-Mail Address and Phone Number for confirmation. Appointment Times should be scheduled between the hours of 10:00 a.m. - 4:00 p.m. Monday - Thursday, and 10:00 a.m. - 2:00 p.m. on Saturdays. Our offices are closed on Friday, Sunday and all major Holidays.
What day would you like to schedule an appointment?
At which facility would you like to schedule your appointment?
Is this appointment for more than 1 person?
Yes - 2 people
Yes - 3 people
Yes - 4 people
Yes - 5 or more people
What immunization and/or services will you be receiving?
Hepatitis A Vaccine - Adult
Hepatitis B Vaccine - Adult
HPV Cervical Cancer Vaccine - Adult
Influenza Vaccine [Flu Shot]
IPV [Polio] Vaccine - Adult
Japanese Encephalitis Vaccine
Meningococcal [meningitis] Vaccine - Adult
MMR Vaccine - Adult
Pneumonia Vaccine
Other [not listed]
Rabies Vaccine
Shingles Vaccine
Td/Tdap Vaccine - Adult
Typhoid [injectable] Vaccine
Typhoid [oral pills] Vaccine
Varicella [Chicken-Pox] Vaccine - Adult
Yellow Fever Vaccine
Lab - Titer Testing for Immunity Verification
Confidential Testing
Urine Drug Screen
Do you have any comments, questions, or suggestions?
Contact Information
First and Last Name
Phone Number You Can Be Reached At
E-Mail Address
Are you requesting Immunizations for International Travel?
Yes   No
If Yes, what is your departure date?
What is your return date?
Where are you traveling to?
What is the purpose of your trip?
Additional Information/Comments
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