Forms

Based on your age, please fill out the appropriate form below and bring it with you on the day of your appointment. Blank forms are available onsite if you are unable to print it at home.

Standard COVID-19 Vaccine Administration Form Age 12 or Older)

Child COVID-19 Vaccination Form (Age 6 months through 11 years old)

Emergency Use Authorizations (EUA) Fact Sheets for Recipients and Caregivers

Pfizer-Biontech

EUA Fact Sheet for Recipients and Caregivers age 6 months and older  UPDATED 4/18/23

Moderna

EUA Fact Sheet for Recipients and Caregivers age 6 months and older UPDATED 4/18/23

Novavax

EUA Fact Sheets for Recipients and Caregivers UPDATED 10-19-22

Emergency Use Authorizations (EUA) Fact Sheets for Healthcare Professionals

Pfizer-Biontech

EUA Fact Sheet for Healthcare Professionals age 6 months and older - UPDATED 4/18/23

Moderna

EUA Fact Sheet for Healthcare Professionals age 6 months and older - UPDATED 4/18/23

Novavax

EUA Fact Sheet for Healthcare Professionals - UPDATED 10/19/22