Thanks for your interest in the COVID-19 vaccine.  We are currently scheduling for vaccinations.

Please complete the form with your information.  We will contact you as soon as possible with an appointment date and time.


Do I qualify for a Booster dose of the mRNA vaccine?

The State of Louisiana along with the Centers for Disease Control and Prevention (CDC) now recommends that people whose immune systems are compromised moderately to severely and are fully vaccinated with an mRNA (Pfizer or Moderna) COVID-19 vaccine should receive an additional dose of that same mRNA COVID-19 vaccine. Patients may self-attest to their condition by completing and signing this form.

People should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them.

How much does the vaccine cost?

The vaccine is FREE.

Does my insurance cover the cost to administer the vaccine?

Boudreaux’s Pharmacy will attempt to charge your insurance when applicable.

How will I know when I'm scheduled to receive the vaccine?

Boudreaux’s Pharmacy will contact you with an appointment date and time.


* indicates required

Have you ever had a severe reaction to a vaccine? *

If you are requesting a booster of your mRNA vaccine, are you moderately to severely immunocompromised based on the above criteria in the FAQ section? If this is your first shot, please answer “N/A”*

Vaccine being requested: *