Covid- 19 Vaccine
COVID-19 Vaccine Dose #2  Pre-Registration - Alpine Medical Clinic
***Please read***
We are currently accepting a waitlist of patients awaiting their second dose of Moderna on a last-minute cancellation basis only.
Alpine is currently only permitted to administer the second dose in the case where the dose would otherwise be wasted such as a last-minute no-show.
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I Need Vaccine Dose Number
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First Name *
Last Name *
My COVID vaccine dose #1 was: *
My COVID Vaccine dose was on *
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Date of Birth *
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Your Health Care Provider (Province) *
Your Health Care Number * *
Have you ever been a patient of Alpine Medical Clinic? * *
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