Please review & complete all 3 steps on this page to set up your appointment for the COVID Vaccine.


  1. You must be 18 years old or older to receive this Vaccine.

  2. You cannot change manufactures of vaccine. We will only be administering the Moderna vaccine. You can find the EUA for this product here.

  3. By booking the appointment you agree to the HIPAA agreement found here.

  4. You will need to fill out screening & consent forms on the day of your vaccine.

  5. We will have paper copies of all of the above on the day of the event if you would like a paper copy.

  6. You will need to plan to wait at the location between 15-30 minutes after your vaccination to be observed by one of our nurses.

Step 2. Fill out Sign up form

Answer all 10 questions and hit submit. Step 3 (Booking your appointment) is only available after submitting this form. Fill out 1 form for every person signing up for the vaccine. If we do not have this form filled out your appointment will be cancelled.

We look forward to serving you at the vaccine event!