Rite aid consent form 2025

1. Click ‘Get Form’ to open the rite aid consent form in the editor.
2. Begin by filling out your personal information, including your name, date of birth, age, phone number, and address. Ensure all fields marked with an asterisk (*) are completed.
3. Indicate which vaccine(s) you wish to receive today and provide any relevant medical conditions. If your weight is less than 110 lbs., enter it in the designated field.
4. Answer the screening questions regarding your health status. Select 'Yes', 'No', or 'Don’t Know' for each question to help determine vaccine eligibility.
5. Authorize the pharmacist to send copies of your vaccine documents to your primary care provider by selecting 'Yes' or 'No'.
6. Review the acknowledgments regarding privacy practices and vaccination information. Sign and date the form at the bottom.

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