COVID-19 Vaccination Information
Pomperaug Health District has scheduled several COVID Vaccination clinics at our office for May and June. We will be using the Moderna vaccine; the clinics are for persons 18 years and older.
May 26, 2:30 – 4:00 PM
June 2, 2:30 – 4:00 PM
June 9, 2:30 – 4:00 PM
Appointments are required; call 203-264-9616, ext. 0
Our vaccination clinics are by appointment only.
Some helpful hints for our clinics:
- After you schedule your appointment, download the forms for the vaccine that you will be receiving. They can be found in the download section of this page.
- Read the fact sheet for the vaccine that you will be receiving.
Moderna EUA/Fact Sheet
Pfixer-BioNTech EUA/Fact Sheet
- Complete the Consent Form form ahead of time and bring it to the clinic. Moderna Consent Form
Pfizer/BioNTech Consent Form
- Bring a copy of your insurance card. We can bill insurance for the administration cost of the vaccine.
- Arrive at the clinic for your appointed time. Plan on at least 20-30 minutes at the clinic. There will be a 15-minute waiting time after you receive your vaccine for precautionary observation.
- You must schedule an appointment for a second dose at the time of your first vaccination. The second dose should be given 28 days after the first dose.
Other Options for COVID Vaccination Appointments
Consider” signing up for V-Safe. It is a voluntary smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Here is the link for more information: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafe.html
- Fact Sheet for Recipient and Caregivers Emergency Use Authorization (EUA) of Moderna COVID-19 Vaccine (18 years & older) (614KB)
- Moderna - COVID-19 Vaccination Consent Form (REV 5/19/21) (220KB)
- Fact Sheet for Recipient and Caregivers Emergency Use Authorization (EUA) of Pfizer COVID-19 Vaccine (12 yrs. & older) (554KB)
- Pfizer - COVID-19 Vaccination Consent Form (REV 5/11/21) (222KB)
- Letter for Absentee Parent - Authorizing Consent to Vaccinate Child (96KB)
- PDDH HIPAA Privacy Notice (492KB)