COVID-19 Vaccination Information
Thank you for your interest in the COVID-19 vaccination.
Please complete the form below to register to receive the vaccine for COVID-19.
Documentation required for minors (ages 12-17) receiving the Covid-19 vaccine:
- Parents/Legal Guardians bringing minor must present a valid form of ID (driver’s license) at the time of vaccine
Notarized written consent in cases where the parent/guardian is not present at the time of vaccination
- Parents may also call 502-SHOT to give verbal consent before vaccination if unable to provide written documentation
- Notarized Affidavit (link below)
- Letter of written consent by Children’s Division, or designee, for all minors under the care of Department of Social Services/Division of Youth Services
- Documentation of proof if pregnant/married/emancipated minor
- Documentation from person/entities, such as governmental or nonprofit agency, if the youth is homeless
Click the link below to access the Affidavit form. The form can be completed online, then printed.
A third dose of the PfizerNBioTech vaccine may be administered to moderately to severely immunocompromised people due to a medical condition or combination of immunosuppressive medication or treatments including but not limited to the following:
- Receiving active cancer treatment for tumors or cancers of the blood
- Received an organ transplant and are taking medicine to suppress the immune system
- Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
- Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
- Advanced or untreated HIV infection
- Active treatment with high-dose corticosteroids or other drugs that may suppress immune response