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)
FDA Approved and Emergency Use Authorizations (EUA) Fact Sheets for Recipients and Caregivers
Pfizer-Biontech and Comirnaty
Moderna and Spikevax
EUA Fact Sheets for Recipients and Caregivers UPDATED 10-19-22
CDC Approved Emergency Use Instructions (EUI) Fact Sheets for Healthcare Providers and Recipients and Caregivers
EUI Fact Sheet for Healthcare Providers -UPDATED 6/24/22
EUI Fact Sheet for Recipients and Caregivers-UPDATED 6/24/22
EUI Fact Sheet for Healthcare Providers - UPDATED 6/24/22
EUI Fact Sheet for Recipients and Caregivers - UPDATED 6/24/22
V-safe Information - V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination.