COVID / FLU SHOT APPOINTMENT

(613) 518-0022
info@jpharmacy.ca
Mon. - Fri. 8:00 – 20:00 Sat. 8:00 - 14:00 Sun. Closed

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COVID / FLU SHOT APPOINTMENT

MINOR AILMENTS APPOINTMENT

FLU SHOT / COVID VACCINE APPOINTMENT FORM

First Name *

Last Name *

Phone Number *

Email Address *

Type of the requested shot *

PLEASE NOTE FLU / COVID SHOT IS ONLY AVALIABLE ON SATURDAY BETWEEN 9 AM AND 1 PM AS IT'S SHOWN IN THE CALENDAR BELOW
However, if this is an urgent matter that needs to be done during the weekdays, please contact the pharmacy and they accommodate you

Preferred Date / Time *

Comments

I AGREE TO TRANSFER MY INFORMATION IN THIS EFORM ELECTRONICALLY AND I FULLY UNDERSTAND THE RISK.

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