Vaccine Appointment
Please select the available time slot that works best for you.
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Vaccine(s) requested:
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Shingles (age 50 and over)
Tdap [tetanus, diphtheria, and pertussis] (age 10 and over)
Meningococcal ACYW-D or ACYW-T (age 11-12 and 16-18)
Hep A/Hep B-Twinrix (age 18 and over)
RSV (age 60 and up AND based on medical condition for eligibility, and pregnant patients at 32 to 36 weeks)
Pneumonia (age 19 and up)
Flu vaccine (age 4 and up)
High Dose Flu vaccine (age 65 and up)
Covid-19 (age 18 and up)
Name
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Date of Birth
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Please note that we are unable to bill vaccines for children under 18 that are covered by Medicaid or any of their HMO's (Va Premier, Optima, Anthem Healthkeepers)
Type of Insurance (Anthem, Express Scripts, Optum-Rx, etc)
Please note we are unable to bill vaccines for Humana or Tricare patients and for children under 18 that are covered by Medicaid or any of their HMO's (Va Premier, Optima, Anthem Healthkeepers)
Best Contact Number
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Email
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