Call Back Request: COVID-19 Vaccination

Name*

First Name

Last Name

Phone Number*

Is this a cell phone?

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Zip Code*

What County do you live in?*

Miami-Dade Broward Palm Beach

What is your age today? (We follow CDC and Department of Health guidelines)*

65 and older Under 65

Please invite me to the next "Ask the Doctors" Telephone Town Hall

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