Vaccine Intake Forms
Our intake forms can be used for the COVID vaccine (only) or for other vaccinations, to help screen the health of the patient and obtain up-to-date before seeing a doctor.
Call 800-4WILMER (800-494-5637) Click here to sign up for email invoice
Wilmer Customer Service
wcs@4wilmer.com
Marketing wilmer@4wilmer.com
Our intake forms can be used for the COVID vaccine (only) or for other vaccinations, to help screen the health of the patient and obtain up-to-date before seeing a doctor.