Important: Fill out the COVID-19 Vaccine Screening and Consent Form

Importante: Favor llenar el formulario de selección y consentimiento para la vacuna para la COVID-19

Please print, fill out and bring this form with you to your appointment:
Si usted califica, favor imprimir este formulario, llenarlo y traerlo a su cita:

English Spanish

In case you can't bring your form we will provide you with one.
En caso de que no pueda traer el formulario, nosotros le entregaremos uno.

 

Book your appointment now for the Pfizer and Moderna Vaccines.

Book your appointment at
Miami
Book your appointment at
Hallandale

Find more information about these vaccines:
Pfizer    |    Moderna

To suscribe to newsletter,
validate that you are a human