This form is intended for local healthcare employers. If you are an employee of a local healthcare agency, you do not need to fill out this form.
If your organization employs any of the workers outlined here, a designated contact person from your organization should fill this form out.
If you are uncertain if your organization falls into Phase 1A, please refer to the Minnesota Dept. of Health guidance here.
The type of vaccine available from the Winona County Public Health Department is the Moderna. This vaccine has been rigorously tested and is safe and effective. This vaccine is given in a 2 dose series, 28 days apart. Employees must commit to receiving the 2nd dose in order to receive the 1st dose. Before an employee receives the COVID-19 vaccine, a medical provider will share information about the vaccine and instructions for what do to after they receive the vaccine.
Note: If an individual has questions about whether they should receive the COVID-19 vaccine, please encourage them to consult with their healthcare provider.
If you have any questions about this form, please contact us at Winona County Public Health by emailing firstname.lastname@example.org.