COVID Vaccine Appointment Cancellation

***If this is an emergency or you are experiencing chest pain, shortness of breath, or an allergic reaction, please call 911 or report to your closest Emergency Room immediately. Do not use this form for urgent medical needs.

Use this form to cancel your COVID-19 vaccination appointment at Inspira Medical Center Mullica Hill or Vineland.

Due to high demand and limited vaccine supply, we cannot accommodate rescheduling requests at this time. If you would like to make a new appointment with Inspira, please check our vaccine scheduling site.

FIrst Name

Last Name

Email Address

May we send you health information by email?

Yes

Telephone

Date of Birth

Appointment Date and Time You Wish To Cancel

CAPTCHA

Math question 1 + 12 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

Click "submit" to send us your request. We'll get back to you soon to finalize your appointment.