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 booster shot of the Pfizer vaccine may be administered 6 months after completion of the Pfizer series. It is approved for only people ages 18 and older, and is limited to the following criteria:
|CATEGORY||AGE RANGE OF POPULATION||QUALIFYING CRITERIA|
|Advanced age||65+||Age only|
|Long-Term Care residents||18 years and up||Resident of long-term care facility|
|Patients with underlying medical conditions||18-64||
|Patients with increased risk for COVID-19 exposure due to occupational or institutional setting||18-64||
*** If registering for the booster vaccine, please bring your Covid Vaccination Card with you to your appointment. ***