Step 1

Below is a link to our Vaccine Only Consult demographics form and a link to our ID image upload portal.   Please fill out form completely and make sure you received confirmation of submission.  Please also upload a copy of a government issued ID for the patient (if the patient is a minor, upload a copy of the ID for the parent or guardian).  ID is required for all services.

Regarding the security of these forms:  Click here to find our more about how we secure the information you submit online.  If you have any concerns about submitting your information online, please contact our office.

Please make sure you fill out the form below.

STEP 1

Vaccine Only Appointment Paperwork

STEP 2

Upload image of ID HERE