COVID-19 Vaccine Appointment and Consent Form

For Patients with Insurance, the VACCINE IS FREE which is provided by the government, and all Insurance plans, are required to cover the vaccine without any deductible or copay
For self-pay patients (with no insurance), although the VACCINE IS FREE, we will charge a nominal fee of $50 as administration fees.
Once your appointment is scheduled, please mark your calendars to arrive on time on the day of your visit. If you arrive late, your visit will be canceled automatically and will need to be scheduled again on the website. (Please do not arrive more than 10 minutes earlier than your appointment time due to limited parking and seating space)
In case of any sickness or if you test positive within 14 days of your scheduled appointment for Covid vaccine, please cancel your existing appointment and reschedule to a later date.
Appointments not canceled 24 hours in advance will be charged $50 as no-show Fees.

Please wear loose clothing so your shoulder area is easily accessible for the injection.
Please do not come earlier than 10 minutes of your appointment time due to limited parking, also please do not come earlier than 5 minutes inside the building due to limited office space with a social distancing protocol in effect.
Once you are parked, please text your arrival to (470-670-6514). We will let you know when you can enter the building due to limited space and social distancing.
Please bring a government-issued ID, proof of employment for healthcare workers, etc, and your insurance card, even if you have submitted it online (In case of technical glitches).
Once you are checked in and received your vaccine, you will be directed to the waiting area for a self-timed 15-minute observation. You may leave after 15 minutes after the shot if you do not have any side effects. (Incidence of immediate side effects are very low).
If you have any symptoms post-vaccination, please feel free to schedule an “Urgent Care” visit-in-person or tele-visit by visiting our website at wilsonswellness.com.
If you did not get any side effects from the vaccine, please book your next appointment for the second dose, 4 weeks from the date of the first dose.
Please continue to follow social distance protocol and wear a mask even after receiving this dose of vaccine.
DO NOT FORGET to register for after vaccination health checker at vsafe.cdc.gov

For privacy reasons, we do not allow any audio or video recording at the testing site
We may close our centers due to inclement weather

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