In preparation to receive a vaccine at Buckley's Drug Store, please fill out the following contact information and consent form below. Please make sure to include the pictures of your Medicare, medical AND pharmacy insurance cards if you have insurance! These pre-appointment procedures and precautions are in place to ensure that all safety and health measures are being taken for both yourself and our staff. We are making sure to sanitize frequently used areas and surfaces. For your convenience, you can now use this form to schedule all of your vaccines! ALL of our COVID-19 vaccines will be given by appointment ONLY, following the rules given to us by the state and the CDC.