20450919 – DEMO: Demonstration Co. – Kohll's Rx Vaccination Clinics

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Vaccination Clinics

Vaccination Clinic

Demonstration Co.

URL

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Confirmation

Appointment Scheduling

Choose your Tuesday, September 19, 2045 appointment time(Required)

Flu Vaccine Selection

Would you like to receive an Influenza vaccine shot?(Required)

Influenza vaccine shots are available to those who qualify for an Influenza vaccine. Your vaccine administrator can help you determine eligibility.

YES

NO

Which Influenza vaccine would you like to receive?(Required)

Standard Dose

High Dose for individuals 65 or older

COVID-19 Vaccination

Would you like to receive a COVID-19 vaccine shot?(Required)

COVID-19 vaccine shots are available to those who qualify for a COVID-19 vaccine. Your vaccine administrator can help you determine eligibility.

YES

NO

Which COVID-19 vaccine would you like to receive?(Required)

Monovalent COVID-19 Booster - Moderna

Monovalent COVID-19 Booster - Pfizer

Shingles Vaccination

Would you like to receive a Shingles vaccine shot (Shingrix)?(Required)

Shingles vaccine shots are available to those who qualify for a Shingles vaccine. Your vaccine administrator can help you determine eligibility.

YES

NO

Pneumonia Vaccination

Would you like to receive a Pneumonia vaccine shot?(Required)

Pneumonia vaccine shots are available to those who qualify for a Pneumonia vaccine. Your vaccine administrator can help you determine eligibility.

YES

NO

Which Pneumonia vaccine would you like to receive?(Required)

Prevnar 20

Pneumovax

Hepatitis Vaccination

Would you like to receive a Hepatitis vaccine shot (Prehevbrio)?(Required)

Hepatitis vaccine shots are available to those who qualify for a Hepatitis vaccine. Your vaccine administrator can help you determine eligibility.

YES

NO

Biometric Screening

Would you like to sign up for Biometric Screening?(Required)

We'll measure: Blood pressure, Weight, BMI, Glucose, and a Lipid panel which tests for cholesterol levels.

YES

NO

Your Information

Name(Required)

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Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

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Phone

Date of Birth(Required)

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