COVID-19 Vaccine Appointment

You have been added to the COVID-19 vaccine appointment list at Southern Pharmacy – Leachville


A Southern Pharmacy staff member will contact you shortly to schedule your COVID-19 vaccine appointment


Please follow the steps below to streamline the vaccination process


1.  If possible, print and complete the COVID-19 Immunization Consent Form located here: 

COVID-19 Immunization Consent Form


2.  Review the Vaccine Recipient information located here:

Vaccine Recipient Information


3.  Bring the following documents to your vaccination appointment:

Completed and Signed COVID-19 Immunization Consent Form

Insurance Card or Medicare A/B Card (Red/White/Blue)


4. Please arrive at your scheduled COVID-19 Vaccination Appointment at your schedule time.  Due to the storage requirements of the Moderna COVID-19 Vaccine, all doses must be given in a timely manner

If you have any questions, please contact Southern Pharmacy – Leachville at 870-539-6831 or [email protected]

Additional Resources




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