COVID-19 Moderna Booster Dose
This clinic will only have Moderna available. The CDC along with Will County Health Department have approved mixing vaccine providers.
Please check the boxes acknowledging these conditions
*
I have my vaccine card or other proof of vaccination
My 2nd dose was more than 6 months ago
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Moderna Booster Appointment Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Zip Code
*
Date of Birth
*
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Month
-
Day
Year
Date
Appointment
*
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