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

Free

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.