By submitting this form, you understand;
1. The Patient is responsible for medical or pharmacy co-pays of vaccine, vaccine administration, and delivery.
2. There is a $60 Delivery Fee per address per trip in Polk County. Additional travel charges apply for appointments beyond the primary service location(s).
3. Individuals receiving a COVID-19 vaccine AND meeting one of the following conditions qualify for delivery at no charge.
a. Medicare recipient, OR
b. Age >60 years, OR
c. Age 18-59 with disability.
1) A pharmacist will contact you in 2-3 business days for a pre-appointment screening.
2) There is a $60 delivery fee per trip per residential address for home delivery in Polk County. Some individuals qualify for delivery at no charge. Credit card information will be collected during the pre-appointment call to reserve your appointment.
3) Partial refunds will be issued for cancellations made >72 hours in advance.