NYS FORMS
COVID-19

COVID-19 CONSENT FORM

(NEEDED BEFORE YOU HAVE AN APPOINTMENT)

Please click the button below to download and fill out the COVID-19 Consent Form.  This form is required by the state of New York to receive a COVID-19 vaccination and must be provided to our staff prior to your appointment.


COVID-19 SELF REPORTING FORM

(AFTER YOU’VE BEEN SCHEDULED, BUT BEFORE YOUR APPOINTMENT)

Once you have an appointment date and prior to your appointment, you must fill out and submit the required NYS COVID-19 Vaccine Self Reporting Form online.

 
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