CDC & NYS COVID-19 Vaccination Forms, Documents, Checklists
CDC & NYS COVID-19 Vaccination Forms, Documents, Checklists
NYS COVID-19 Vaccination Handbook
- NYS COVID-19 Vaccination Program Handbook (10/16/2020)
Provider Enrollment and Support
- NYC DOHMH COVID-19 Vaccination Enrollment Letter
- NYS COVID-19 Vaccine Provider Profile Addendum
- CDC COVID-19 Vaccination Program Provider Agreement
- CDC Supplemental COVID-19 Vaccine Redistribution Agreement
- Guidance on COVID19 Screening Checklist
- Ordering COVID-19 vaccine in the New York State Immunization Information System
- Vaccine hospital ordering letter
COVID-19 Vaccination Clinic Forms and Resources
- NYS Pre-Screening Vaccine Form
- NYS Am I Eligible (link)
- NYS COVID-19 Vaccination Form
- Screening Checklist for the COVID-19 Vaccine
- NYSDOH COVID-19 Vaccine Tracker
- V-Safe (CDC's after vaccination Health Checker)
- Immunization Screening and Consent Form (optional)
- Moderna and Pfizer guidance and forms
- Moderna standing order
- Pfizer standing order