COVID-19 Vaccine Consent Form
Warning! Completing this form will allow you to schedule an appointment to receive the Moderna COVID-19 vaccine at Hawthorne Pharmacy on 2534 Broad St, Camden, SC 29020. If you would like to receive the vaccine at a different Hawthorne Pharmacy location, please click this link to access the store-specific form for your desired Hawthorne location. Thank you!
The Moderna COVID-19 vaccine is a 2-dose series seperated by 28 days. You will be able to sign up for the second dose during your first dose appointment.
Moderna COVID-19 vaccine Emergency Use Authorization (https://www.fda.gov/media/144638/download)