Moderna Vaccine Screening and Consent Forms

Thank you for booking your appointment with the State of Florida Division of Emergency Management’s Senior First COVID-19 Vaccination initiative. To speed up your check-in process, please download, print, complete, and bring the consent forms. Click below to download.

Please call 561-486-7221 with any questions or if you need to cancel your appointment.

Consent Form – English | PDF
Consent Form – Spanish | PDF
Consent Form – Creole | PDF