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Kohlls Rx

Locally owned and operated since 1948.

402-408-1990 / 866-500-7800
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You are here: Home / Pharmacy / Vaccines & Flu Shots / Travel Vaccines

Travel Vaccines

Please fill out the online form below in its entirety. Once submitted, a pharmacist will contact you within 5 business days to finalize your appointment and review the recommended medications and vaccinations for your travel.

Most vaccinations need to be administered a minimum of 10-14 days prior to travel so we recommend scheduling your appointment at least 30 days prior.

Most Common Travel Vaccine/Medication Pricing

  • Traveler's Diarrhea Treatment
    • Azithromycin 500 mg #2) – $5
  • Malaria Prophylaxis
    • Doxycycline 100 mg – $0.50 per tablet
    • Atovaquone/proguanil (Malarone) – $3 per tablet
  • Yellow Fever Vaccine
    • YF-Vax – $215
  • Typhoid Fever Vaccine
    • Typhim – $150
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  • Contact Information

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  • Travel Itinerary

    Please list the country and cities within each country that you will be traveling to. Arrival date is the date you will arrive in that country. Departure date is the date you will leave from that country.
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  • About Your Travel

  • School/study, pleasure, business, mission work, etc.
  • Indoor, A/C, screens, tents, open air, etc.
  • Hiking, climbing, scuba diving, site seeing, working, night life, etc.
  • Our trained Kohll’s pharmacists will make recommendations based on your travel itinerary, but please list any vaccinations/medications you know you would like to receive.
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  • Current Medical Information

  • Please list all current medical conditions and any recent surgeries.
  • Please list all current medications not currently filled at Kohll’s Rx.
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  • Immunization / Vaccination History

    Please bring in a copy of your immunization history to your appointment or fill out the following information with the dates of your previous immunizations.
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    • Insurance Information

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      Pharmacy / Prescription

       

    • 6 digit number, required for processing
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        • Preferred Kohll's Rx Location

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          In order to speed up the vaccination process, we ask that all vaccine recipients fill out our patient consent form before their appointment.
        • Patient Consent Form

          In order to speed up the vaccination process, we ask that all vaccine recipients fill out our patient consent form before their appointment.
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        • Females Only

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        • Malaria Prophylaxis Recipients

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        • Traveler's Diarrhea Treatment Recipients

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        • Additional Questions

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        • Appointment & Consultation Fee

          A non-refundable $25 consultation fee applies per person. A trained pharmacist reviews your submitted information, determines the recommended medications and vaccinations, and will answer any questions at the time of appointment. Due to the time required, the fee is non-refundable.

          Forms submitted will not be addressed until payment is received.
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          Personalized consultation fee of $45 per family applies.
        • Please list any additional household/family members who will be traveling with you and participating in this consultation. Be sure to use the same names when submitting this form for each traveler.

          A separate form must be submitted for each individual.
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        • Payment Information

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          Supported Credit Cards: American Express, Discover, MasterCard, Visa
           
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        • Signature

        • Max. file size: 300 MB.
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        Kohll's Pharmacy & Homecare'

        Kohll's has been serving patients in Omaha, Lincoln and western Iowa since 1948. We provide high-quality service to better your health.

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        Do you have COVID-19 questions? Use our Contact Form to receive the quickest response.

        Call 402-973-1947 for our COVID-19 team.

        • 2915 Leavenworth St / 402-342-6548
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