Please request to schedule your COVID-19 Vaccine appointment here.

Please select 1 slot per person on the calendar below. If you enter more than 1, you will be rejected.

*Appointment confirmation will be sent to your email within 24 hours. If you haven’t received it please make sure to check your junk or spam mail as well as your inbox.

Please do not call our office regarding the COVID-19 vaccine.

Prior to Your Appointment:

  1. Email a copy of your insurance card (front and back), name of policy holder and his/her date of birth to
  2. Download the COVID-19 Vaccine Questionnaire & Consent Form and fill out

Your Appointment Date:

  1. Bring the filled  COVID-19 Vaccine Questionnaire & Consent form
  2. Bring your original insurance card
Important Updates:
Following the FDA’s regulatory action on March 29, 2022, CDC updated its recommendations to allow people over the age of 50 who received an initial booster dose   at least 4 months ago to be eligible for another mRNA booster to increase their protection against severe disease from COVID-19. 

予約後のご案内は24時間以内にEmailで送信されます。届かない場合は、迷惑メール(Junk Mail)に送信される場合がございますので、そちらもご確認ください。


ワクチンに関する お電話でのお問い合わせはご遠慮ください。



  1. 保険証のコピー(表と裏両方)とポリシーホルダーのお名前と誕生日をメールでcovid@kuraokaclinic.comまでお送りください。
  2. COVID -19の質問表/同意書をダウンロードしてご記入ください。


  1. 記入されたCOVID-19質問表/同意書
  2. 保険証

Please select 1 slot per person. If you enter more than 1, you will be rejected.

ご予約日時は1つだけお選びください。 2箇所以上に入力された場合は、全てが消去されます。お気をつけください。

August 2022
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