WARNING: DO NOT DOUBLE BOOK. If you attempt to make 2 entries in your own name/ email/ phone # we will CANCEL ALL DUPLICATE APPOINTMENTS.
Vaccines will be administered from our administrative office at 505 Main Street in Northport, NY.
When you come to your appointment you MUST BRING the following items:
1.
Proof of Eligibility A completed Proof of Eligibility Form which can be found
HERE . You will receive a submission ID indicating completion.
Print a copy and bring it with you to your appointment. If you cannot submit the form online, it will be available at the vaccination site. We are required to verify that you meet the eligibility requirements as per New York State Guidelines. These guidelines continue to change. If you are not eligible at this time, please check back periodically.
2. Photo ID (Driver’s license or passport)
3. Current insurance card
4. Completed COVID-19 Vaccine Data Sheet that can be accessed HERE. Please bring this form with you to your appointment.
5.
Completed New York State Department of Health COVID-19 Immunization Screening and Consent Form that can be accessed
HERE.
Please bring this form with you to your appointment.
