Drive-Thru Vaccine Clinic

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For more information, please feel free to contact:

Debby Crowell
dmcrow56@gmail.com
256-227-3185

For Insurance Information:
Tonya Brown
tonyajane73@gmail.com
256-773-1768

Email *

Last Name *

First Name *

Phone Number *

Please select the time you would like to attend below: *

9:00 AM

9:15 AM

9:30 AM

9:45 AM

10:00 AM

10:15 AM

10:30 AM

10:45 AM

11:00 AM

11:15 AM

11:30 AM

11:45 AM

12:00 PM

12:15 PM

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12:45 PM

1:00 PM

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1:45 PM

2:00 PM

2:15 PM

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2:45 PM

3:00 PM

3:15 PM

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3:45 PM

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4:15 PM

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4:45 PM

5:00 PM

5:15 PM

5:30 PM

5:45 PM

6:00 PM

6:15 PM

6:30 PM

6:45 PM

7:00 PM

7:15 PM

7:30 PM

7:45 PM

Please check the vaccinations you would like to receive: *

Select all that apply

Regular Flu

High Dose Flu

Pneumonia (65+)

Shingles (55+)

Tdap (Tetanus, Diptheria, Pertussis)

Required

Please give the name of your insurance carrier:

A copy of your responses will be emailed to the address you provided.

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