Costco flu shot appointment 2026

1. Click ‘Get Form’ to open the Costco flu shot appointment in the editor.
2. 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.
3. Next, provide details about your Primary Care Provider including their name and contact information.
4. 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.
5. Select the vaccines you are requesting by checking the appropriate boxes. Options include various influenza types and other vaccines.
6. Answer the precautions and contraindications questions by checking 'Yes' or 'No' for each item listed. Provide additional information where necessary.
7. Review the Adverse Reactions section carefully. Acknowledge that you understand potential risks associated with vaccinations.
8. Finally, sign and print your name in the Signature/Legal Guardian section to complete the form.

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