Greendale Health Department
Who: Anyone 18 or older
When: Friday, May 14th
- **Your second dose is automatically scheduled for 6/11 at the same time.
Where: Greendale Community Learning Center (Lower Level) 5647 Broad Street
DO NOT schedule a vaccine with us if any of the following is true for you:
1. You have had any other vaccine within the past 14 days
2. You have ever had an allergic reaction to a vaccine or an injectable medication (this includes severe allergic reactions like anaphylaxis that required treatment with epinephrine or EpiPen or that caused you to go to the hospital and/or an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing)
3. You have received antibody therapy or convalescent plasma for COVID-19 treatment in the past 90 days
4. You aren't feeling well, are currently isolated from testing positive for COVID-19, or are in quarantine from an exposure to someone with COVID-19
Fill out with
- your full LEGAL name,
- date of birth YOU MUST BE OVER 18 to receive our vaccine,
- email address for confirmation of appointment
- phone number
- home address
PLEASE BE SURE TO LIST ALL INFORMATION OF THOSE REGISTERING
Please print (if you are able) and fill out COVID-19 Vaccine Consent- which is attached in the "Related Files" section.
Please review the Moderna COVID-19 Vaccine Education Video link and Emergency Use Authorization (EUA) fact sheet link.
If you do not review these prior to your appointment, you will have the opportunity to receive this in-depth information at the clinic.
Moderna COVID-19 Vaccine Education Video https://youtu.be/qKOJSB2QloE
Emergency Use Authorization (EUA) fact sheet for recipients can be found at: https://www.fda.gov/media/144638/download