Macon County Health Dept.

503 N Missouri St.
Macon, MO 63552
(660) 395-4711

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You are here: Home / COVID-19 / COVID-19 Vaccine Forms

January 20, 2021 By Mollie Butner

COVID-19 Vaccine Forms

Before receiving your COVID-19 vaccine, please review the pre-vaccine check list found here.  If you answer yes to any questions, it doesn’t mean you cannot be vaccinated.  If you have any questions please call our office or ask who is administering your vaccine.  You do not need to bring this to your vaccination event.

Please fill out a consent form and bring it with you to receive your vaccine.

If you are being vaccinated in group 1B, fill out the consent form found here.

Please bring a copy of your insurance card.

Review Missouri DHSS Notice of Privacy Practices here

 

Filed Under: COVID-19, Recent News

Macon County Health Department

503 N Missouri St   |   Macon, MO 63552
Primary Phone Number (660) 395-4711
After Hours Number (660) 651-5737

Our Mission

To protect, promote and improve the health and quality of life in Macon County

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