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Lighthouse Pharmacy - Moderna or Pfizer COVID-19 Bi-valent Booster
Personal Information -
*** Come in to the Pharmacy Monday to Friday 9 am to 5:30 pm. ***
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Full Name
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Date of Birth
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Address
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City
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State
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Zip Code
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E-mail Address
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Phone Number
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Your Social Security Number and/or Medicare Number
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Your answer
I agree to wait for 10-15 minutes after I receive the COVID-19 vaccine or 30 minutes after I receive the COVID-19 vaccine if I have a history of serious allergic reactions.
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Yes
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