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COVID-19 Vaccine Information
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What is your race? Check all that apply
Has a health care provider ever told you that you have any of
the following chronic conditions (i.e., one that has lasted
for three months or more)? Check all that apply.
The next few questions ask about falls. By a fall,
we mean when a person unintentionally comes to rest
on the ground or another lower level.
If you fell in the past 3 months, what happened after you fell and had an injury? Check all that apply.
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Please call to set up an appointment.
Are you a current patient at Central Ohio Primary Care?
This form is used for COPC's patient concierge team to help you find a new COPC doctor. It is not intended to request an appointment for a COVID-19 vaccination. Please click here to view the latest COVID-19 updates from COPC.
Enter your first name and phone number so we can contact you and confirm your appointment.
Select a preferred date and time for an appointment. If you would like our team to schedule you at the next available opening, leave the fields blank.
A member of our Patient Concierge team will call you within 1 business day to assist you with scheduling your appointment. Please wait for our team to contact you before arriving to your appointment. If you have questions prior to our phone call, please dial (614) 326-4646, Monday — Friday, 7:30am to 5:00pm.
Thank you for requesting a new patient appointment with Central Ohio Primary Care.
Please call your physician's office to set up an appointment.