Patient Intake Information

Patient Name *

Patient Date of Birth *

Choose Your Vaccine(s)

Pneumonia Vaccine (Prevnar20)

Tdap Vaccine (Tetanus Shot: Tetanus, Diphtheria, and Pertussis)

Shingles Vaccine (age 50 and older)

RSV Vaccine (age 75 and older)

Flu Vaccine (children and adults 64 years old and younger)

Flu Vaccine (65+)

Pediatric COVID Vaccine (Moderna age 6 months – 11 years)

COVID Vaccine (Moderna age 12 and older)

Other Vaccine — Please call for availability (Hepatitis A, Hepatitis B, Meningococcal, MMR, and others)

Cambridge Vaccine Appointment

Category: Vaccine

Description

Description

Forward Pharmacy offers vaccines for the whole family. Please select your date and time below, and then select the vaccine you need. If you need a vaccine that is not on the list, just give us a call. As a reminder, GHC insurance will not cover vaccines outside of their clinics.

If you need to cancel your appointment, you may do so by emailing:
cambridge@forwardpharmacywi.com.

If you have a child under the age of 3, please call our pharmacy at 608.423.3231 to make an appointment.