COVID-19 Vaccination Forms

If you have been contacted by our office and are scheduled to receive a COVID-19 vaccination, please fill out the “COVID-19 SCREENING FORM” below and bring the completed form to your appointment.

Please note, if you currently have COVID-19, have received antibody therapy for COVID-19 within the last 90 days, or have received any other vaccine(s) in the two-week period before your appointment, you will need to reschedule.

 

COVID-19 SCREENING FORM
VSAFE Information Sheet
Emergency Use Authorization (EAU) Fact Sheet