Clinic Hours:
1st Monday & 2nd Wednesday from 9-11:30am
3rd Monday and 4th Wednesday from 1-3:30pm
This form is used to request a vaccine appointment. Appointments are subject to the availability of nurses and the needs of the patient. Information you provide will be used only to contact you, ask basic screening questions, and schedule your appointment. This form is not monitored in real time and should not be used for urgent medical concerns. Information is handled in accordance with privacy laws.
Once this form is submitted, an NSHD nurse will contact you as soon as possible to review screening questions and schedule your appointment.
Thank you!