Reserve Your MODERNA Vaccine

Follow these steps to reserve your vaccine.

1. Reserve your vaccine below. Your vaccine is NOT reserved until you press NEXT below.

2. Complete the remainder of this vaccine consent form online. While this process may seem cumbersome it will make the day of your vaccination so much easier!

Once you press NEXT below you have 30 minutes to complete the ONLINE paperwork to guarantee your reservation. It should only take a few minutes.

I understand that when I hit NEXT on this page I am reserving a vaccine for myself or the person I am helping/representing today. *

I understand

I understand I must complete the whole process within the next 30 minutes (complete my online paperwork and set my appointment) or I may lose my "reservation". *

I understand

Furthermore, knowing that COVID vaccinations are time sensitive, in high demand, and in short supply I will let Oak Ridge Pharmacy know ASAP if for any reason we decide not not complete the process OR cannot keep our appointment. *

I agree

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Last Name *

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Email Address *

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