Important Information

PLEASE CALL THE OFFICE FOR 1ST DOSES (we will email you a link for forms)


1. Fill out the online sign-up form



2. You will be able to schedule your 1st vaccine dose on this form

3. Download a copy of the FDA Moderna Vaccine Emergency Use Authorization (EUA), Facts About COVID Vaccines, & What to expect after getting the COVID vaccine documents

(for your own information)

  (ENGLISH)                (ESPANOL)

4. Once you have submitted the sign-up form and booked your appointment and we have reviewed your form, you will receive a confirmation text message or phone call for your 1st dose appointment.

5. Your appointment is NOT CONFIRMED until you receive a confirmation text message or phone call

6. You will also get a phone call reminder the day prior to your appointment

7. We will automatically make you your 2nd dose appointment about 28 days after your 1st dose.


8. The day prior to your 2nd dose you will receive a phone call to confirm your 2nd dose appointment. You will NEED to fill out the 2nd dose form prior to your appointment. 

This form is required to receive your 2nd dose 28 days after your 1st dose. Please fill out the day before your 2nd dose appointment

COVID Vaccine 2nd Dose:


PLEASE CALL THE OFFICE FOR 2ND DOSES (we will email you a link for forms)

You will NEED to fill out the 2nd dose form prior to your 2nd dose appointment.

Please fill it out 1-2 days prior to your 2nd appointment

Doing this form online will make your 2nd appointment faster and more efficient with less waiting

FDA has authorized a booster dose of Moderna for any adult 18 and up at least 6 months after completing the Moderna or  Pfizer, vaccine.

The FDA has also authorized a Moderna booster for any adult 18 and up who has received a one dose Janssen (J&J) vaccine at least 2 months after their initial vaccine.

A one shot Moderna booster is authorized for anyone who has received Moderna, Pfizer, or Janssen (J&J) vaccines as their primary COVID vaccine series.

To schedule your vaccine, please click on the link below:

Vaccine Information
We only carry the Moderna COVID-19 vaccine.  
It is currently only authorized for persons 18 years old and up

If you need a J&J (Janssen) or Pfizer vaccine please visit the Maryland Department of Health website.

For more information regarding the Moderna vaccine, please visit CDC or FDA websites.

What to expect at your appointment:

1. Arrive at our office at 19710 Fisher Ave, Suite J, Poolesville MD 20837

2. You will be greeted at our front desk and directed to a nurse for your vaccine

4. You will receive your vaccine and a CDC immunization card 

5. You will wait a minimum of 15 minutes for observation

6. You will check out with our front desk

COVID vaccines are done by appointment only.

We will NOT accept ANY Walk-ins under any circumstances.

Due to the storage and handling requirements, COVID vaccines will NOT be given during regular office visits

COST: There is absolutely no cost to the patient. The federal government is supplying the vaccine for free. We do charge a vaccine administration fee to your insurance but we do not collect any co-pays or deductibles from you. 

If you don't have health insurance, we are offering the vaccine completely free of charge.

We ask only the person with an appointment come to the visit. Only exception is for a person needing assistance.


We are offering the vaccine as a community service. Our small staff does not have the resources to answer specific questions about the vaccine (other than for our own patients). If you have questions, please contact your own physician or visit the CDC 

Email is best way to reach us:

COVID Vaccine 1st dose:

COVID Vaccine