•   Fall 2026 COVID-19 Vaccine

      Brown University

    Please use the form below to sign up for a vaccine with us.

    *Please anticipate a wait as we check you in and check in patients ahead of you. Thank you.

    Please note:

    The 2026-2027 COVID-19 vaccine is now available.  People who recently had COVID-19 may consider delaying their vaccine for 3 months. Please speak with your PCP if you have had COVID-19 in the past 90 days.
    It is safe to receive the COVID-19 vaccine & flu vaccine in the same visit. 

  • *

  • Basic Demographic Information

  • Date of birth:*
     / /
    2 digit month, 2 digit day, 4 digit year
  •  -
  • Browse Files
    Cancelof

  • Immunization Screening Questionnaire

  • Have you received a covid-19 vaccine in the last 2 months?*
  • Are you feeling sick today? (If yes, please delay vaccination until symptoms are resolved)*
  • Have you tested positive for COVID-19 within the last 90 days?*
  • Which vaccine(s) will you be receiving with us during your visit?*
  • Have you ever had a serious reaction after receiving a vaccination? Do you have a history of fainting, particularly with vaccines? Has any physician or other healthcare professional ever cautioned or warned you about receiving certain vaccines or receiving vaccines outside of a medical setting?*
  • Have you had a seizure or a brain or other nervous system problem or Guillain-Barré Syndrome?*
  • Do you have a bleeding disorder or take blood thinners such as Warfarin/Coumadin/ Eliquis/Xarelto?*
  • Do you have a history of myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the lining around the heart) either related to or unrelated to receipt of an mRNA COVID-19 vaccine?*
  • Are you moderately/severely immunocompromised from a medical condition/immunosuppressive therapy, including/not limited to: active treatment for solid tumor/hematologic malignancy, solid organ/stem-cell transplant, primary immunodeficiency syndrome, advanced/untreated HIV infection, or active treatment with high dose corticosteroids/other immunosuppressive/ immunomodulatory biologic agents i.e. Humira®, Remicade®, etc.)?*
  • Do you have a history of multisystem inflammatory syndrome (MIS-C or MIS-A)?*
  • COVID-19 VIS: Vaccine Information - The Vaccine Information Statement (VIS) contains helpful information about the above FDA-approved vaccines. If you have questions, the pharmacist will be glad to discuss them with you.
  • Should be Empty: