Covid-19 VACCINATION Information

HOW TO REGISTER FOR OUR PHARMACY’S COVID-19 VACCINATION WAITLIST

STEP ONE:

CALL OUR PHARMACY’S COVID VACCINE HOTLINE: 682-404-8796

 

As soon as we receive a First Dose shipment, we will begin calling for appointments. Do not call and tell us you have received the vaccine elsewhere; simply decline for that reason when you are called by us to make an appointment. We will then proceed to the next person on our list.

OR BOOK ON-LINE AT 

 

Beginning Monday, March 29th, all adults over 16 will be eligible for vaccine.

.

STEP TWO:

ONCE YOU HAVE BEEN GIVEN AN APPOINTMENT, PLEASE PRINT AND FILL OUT THE FOLLOWING THREE (3) REQUIRED FORMS:

1. FORM 1 –COVID-19 Consent and Release Form – please note: do not check either the Pfizer or the Moderna box on this form until you the day you are vaccinated. Wait until you are told by the pharmacy at the time of your appointment which vaccine you are receiving. Please access INSTRUCTIONS FOR FORM 1 here if you have any questions.

2. FORM 2 –Texas Immunization Registry Adult Consent Form- Please access INSTRUCTIONS FOR FORM 2 here if you have any questions.

3. FORM 3 – HIPAA NOTICE. Please access INSTRUCTIONS FOR FORM 3 here if you have any questions.

These are the only forms you are required to fill out. The below documents are additional resources:

V-safe Info Sheet

Moderna FAQ Sheet (English)

Moderna FAQ Sheet (Spanish)

Pfizer FAQ Sheet (English)

Pfizer FAQ Sheet (Spanish)

If you would like to release your vaccine records to another party, please access and fill out IMMTRAC Authorization To Release Official Immunization History.

If you wish to extend maintaining your vaccine records by the State of Texas beyond the five-year statutory period, please access and fill out IMMTRAC Disaster Information Retention Consent Form

.

If you have questions about the forms, please DO NOT CALL THE PHARMACY. We will make any corrections or help complete them at the time of your appointment.

The ADDITIONAL RESOURCES documents posted are for informational purposes only. You will be given access to copies at the time of your vaccination.

STEP THREE:

A) You must bring originals or copies of the following documents to complete the vaccine administration process:

i) Your medical benefits card (what you present to the doctor’s office);

ii) Your prescription drug benefit card (what you present to the pharmacy when picking up prescriptions-some insurance plans have the prescription drug benefit on the same card as the medical benefit BUT NOT ALL PLANS DO);

iii) If on Medicare, any Medicare Supplemental Coverage card;

iv) If on Medicare, your Medicare red, white and blue card; and

v) Your current driver’s license, Official Photo ID or passport.

 

STEP FOUR:

APPOINTMENTS-Please note that we do not know how many doses or which vaccine shipment, if any, we will receive each week. This means that there will be very little advance notice (sometimes less than 24 hours) of your appointment date and time.

Once you receive a call from us confirming a date and time for your vaccination appointment, please arrive 15 minutes before your scheduled appointment so that we may review your paperwork to insure completeness.

IMPORTANT TO NOTE: If you do not have your paperwork completed, forms filled out and required insurance documents and ID copied, please arrive 30 minutes before your appointment AT OUR DRIVE-THRU WINDOW to receive copies of the required forms. Please remain in your vehicle until all paperwork is completed by you so that we may enforce social distancing inside the pharmacy.