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Vaccine Appointment Request

Appointments are set on  first come, first serve basis as they become available. There are no guarantees that we will be able to secure an appointment.  

IN ORDER TO BE VACCINATED, YOU MUST:
• Have a confirmed appointment.
• Show Florida-issued photo ID or photo ID AND two proofs of Florida residency.
If you are 65 years or older, you do not need a note from your doctor.
• If you are 55 to 64 years old, you must have one of the conditions listed below.
• Have a note from your doctor that includes your name, your condition from the list, written recommendation to receive the vaccine, and your doctor's signature - see the example below.






Must be over 65+ or 55-64 with special conditions, or your request will be rejected. Requests will not be considered without date of birth and condition listed.

YOU MUST BE A FLORIDA RESIDENT WHO IS AGE 65 or 55-64 WITH SPECIAL CONDITIONS TO RECEIVE THE VACCINE. No exceptions.  If you do not meet ALL criteria your appointment will be forfeit and you will not receive the vaccine at the time of your appointment.
 
Individuals seeking vaccines must bring ID to confirm their residency. In addition, proof of residency (either full-time or seasonal) can be provided through one of the methods listed here:
 
1. An adult resident must provide the department with a copy of his or her valid Florida driver license issued under s. 322.18 or a copy of a valid Florida identification card issued under s. 322.051.
 
2. An adult seasonal resident who cannot meet the requirements of subparagraph 1. may provide the department with a copy of two of the following that show proof of residential address:
a. A deed, mortgage, monthly mortgage statement, mortgage payment booklet or residential rental or lease agreement.
 
b. One proof of residential address from the seasonal resident’s parent, step-parent, legal guardian or other person with whom the seasonal resident resides and a statement from the person with whom the seasonal resident resides stating that the seasonal resident does reside with him or her.
 
c. A utility hookup or work order dated within 60 days before registration in the medical use registry.
 
d. A utility bill, not more than 2 months old.
 
e. Mail from a financial institution, including checking, savings, or investment account statements, not more than 2 months old.
 
f. Mail from a federal, state, county, or municipal government agency, not more than 2 months old.
 
g. Any other documentation that provides proof of residential address as determined by department rule.

If there is no selection for your condition, you DO NOT qualify at this time to receive a vaccination through our program.  Please contact your health care professional for your options.






YOU MUST BE A FLORIDA RESIDENT WHO IS AGE 65 or 55-64 WITH SPECIAL CONDITIONS TO RECEIVE THE VACCINE. No exceptions.  If you do not meet ALL criteria your appointment will be forfeit and you will not receive the vaccine at the time of your appointment.
 
Individuals seeking vaccines must bring ID to confirm their residency. In addition, proof of residency (either full-time or seasonal) can be provided through one of the methods listed here:
 
1. An adult resident must provide the department with a copy of his or her valid Florida driver license issued under s. 322.18 or a copy of a valid Florida identification card issued under s. 322.051.
 
2. An adult seasonal resident who cannot meet the requirements of subparagraph 1. may provide the department with a copy of two of the following that show proof of residential address:
a. A deed, mortgage, monthly mortgage statement, mortgage payment booklet or residential rental or lease agreement.
 
b. One proof of residential address from the seasonal resident’s parent, step-parent, legal guardian or other person with whom the seasonal resident resides and a statement from the person with whom the seasonal resident resides stating that the seasonal resident does reside with him or her.
 
c. A utility hookup or work order dated within 60 days before registration in the medical use registry.
 
d. A utility bill, not more than 2 months old.
 
e. Mail from a financial institution, including checking, savings, or investment account statements, not more than 2 months old.
 
f. Mail from a federal, state, county, or municipal government agency, not more than 2 months old.
 
g. Any other documentation that provides proof of residential address as determined by department rule.

If there is no selection for your condition, you DO NOT qualify at this time to receive a vaccination through our program.  Please contact your health care professional for your options.

Tue, March 9 2021 25 Adar 5781