$0.00 0

No products in the cart.

Continue Shopping

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)

Copyright 2024 Letourneau's Pharmacy, Inc. All Rights Reserved.