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Vaccine Forms

Please click the links below to fill out your vaccine form before you come in for a vaccine.

We are able to administer all standard vaccinations to adults, and the influenza vaccine to children age 9 and up, without a prescription. For other pediatric vaccinations, we do require a prescription. Vaccines do not require an appointment; however, feel free to call for information on pricing and insurance coverage.

Consent Form for Flu Shot

Consent Form for Covid-19

Consent Form for All Other Vaccines

HIPAA Card (Must Complete if New Patient)

Find Us

349 North Main Street
Andover, MA 01810
Click for Directions

Call or Text: 978-475-7779
Fax: 978-475-1662
Email: info@letourneaus.net

Our Hours

Monday – Friday: 9 a.m. – 6 p.m.
Saturday: 9 a.m. – 1 p.m.
(Saturday hours are Medical Equipment only.
No Prescriptions or Vaccines Available)
Proudly servicing patients in Andover, North Andover, Methuen, Lawrence, North Reading, Reading, Tewksbury, Lowell, Haverhill, Groveland, Georgetown, Boxford, Newburyport, Wilmington, Woburn, Plaistow, Salem, MA, Peabody, Stoneham, Danvers, Gloucester, Atkinson, Salem, NH, and more!
Copyright 2023 Letourneau's Pharmacy, Inc. All Rights Reserved.

CYBER WEEK

20% OFF

Your durable medical
equipment purchase!
We are proud to offer this limited time
deal to make your holidays happy and healthy.
Valid from November 24th to December 2nd
LEARN MORE
This promotion applies to durable medical equipment purchases only, up to $500. No prescriptions, insurance items, or past purchases. Cannot be combined with any other offers. Single-use only. Contact Letourneau’s Pharmacy at 978-475-7779 for details.