C-19 Forms

The consent form below is necessary to receive your shot. If you have a printer, please print, fill out and bring to your vaccination appointment.

• COVID-19 Vaccine Consent Form – English
• COVID-19 Vaccine Consent Form – Spanish

Below are PDF documents for your information:

• Moderna Fact Sheet for Recipients – English
• Moderna Fact Sheet for Recipients – Spanish
• V-safe Information Sheet
  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.