How to use or fill out Costco flu shot appointment with our platform
- Click ‘Get Form’ to open the Costco flu shot appointment in the editor.
- Begin by filling out the Patient Information section. Enter your last name, first name, address, phone number, gender, birth date, city, state, and zip code.
- Next, provide details about your Primary Care Provider including their name and contact information.
- In the Insurance Information section, indicate your payment method (cash or insurance) and fill in any relevant insurance details such as Medicare number and carrier name.
- Select the vaccines you are requesting by checking the appropriate boxes. Options include various influenza types and other vaccines.
- Answer the precautions and contraindications questions by checking 'Yes' or 'No' for each item listed. Provide additional information where necessary.
- Review the Adverse Reactions section carefully. Acknowledge that you understand potential risks associated with vaccinations.
- Finally, sign and print your name in the Signature/Legal Guardian section to complete the form.
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