Rx Vaccine Bonus Program Interest

Ohio's Medicaid managed care programs have developed an additional vaccine incentive bonus program, just for pharmacies. This is to acknowledge the pharmacy team's efforts in educating, motivating and vaccinating Ohio’s Medicaid population. Please respond to this survey with your interest.

1. Pharmacy name *This question is required.

2. Pharmacy address *This question is required.

3. Vaccine point person *This question is required.

4. Vaccine point person email: *This question is required.

5. Are you interested in participating in the new Medicaid Rx Vaccine Bonus Program? (please refer to the email sent to you for specific program details) *This question is required.

6. Are you interested in receiving print material about the COVID-19 vaccine to share with patients? (door hangers, flyers, posters, etc.)