I understand the benefits and risks of the vaccine. 152 0 obj <>stream EMC To schedule a Johnson & Johnson COVID-19 vaccine, you can go to chcsek.org and click the COVID Vaccination Form button. h�ms�8���>��ɠw�L'3~ɋ�M��%W�Ħ w��`�k���J`��ؙ��E��V�ٕW�P�'p)A��+I�7E�� 3�ƪ��h� �5%�S0Ԍ0Š���B� f���;�` �7UP� �Ԇ%���ǚ�_00�D8�a ���p"E� �5�HЁ��4~�݃`k��$�?~�N~�ga����&%��i>/�������t\�Y���149�v���)�s�M������������}��wu��LD�G3XX�Z���{2]�^�»̋Y2�=¼�/U�x{�,~�^x�,��y�����u��0WF}� ��y�=�x���aI�+��翢#�s�����b�=Mf���]�Ȓ)�L�"���Sd��I��%�Lf�w~��r��`흹Յe���G/Lg� �O��2�Xͭ�QR��d��{�iJ����Ob�w�H�)Ρ�e^xw������2E�M����$�?x�ټ7_f��ӬX��Ǥ��b=� ���2���}������^��_���q���YmR>.#�q��v)�Ψ��Rխ�M��.i1�Ȳ����»�Ūr�H�-X�'{��|N�����+L�]����mv�'�o�&;G�|:y�f���I�6/�8hc����Hq�_G���5u� Documentation for Minors for Vaccine. `X$Ƌ�YV:�f�(w��� �uZx��r�UE��� 0?�̴��L������5o����"1��K��XCM:$,QE�q�D3����� V9|��ϫܔ`J��P��lp_���/�S�k�p�-��I����X-pn� ����uH-s��&� Includes information on eligibility, vaccine types, available registration systems and unique registration links that have been made available. See the numbers. h�b``�f``z����x@���1�����$ i(f`X� ��f�3�e�eX �9X��2E1?�IƗ����2|�PO�e������x�L30 ��,�;�& �L�G�@�Xf��fe`�� "�p � �h� 0 0 18 18 re County of San Luis Obispo Public Health Department ... and Self-Attestation. Gavin Newsom formed a COVID-19 Testing Taskforce in April 2020 to look into racial inequities. 0 �ɼ f 1 g };�cm�τ�8^���O\'�&���yb����з��}���x���� �V�u����J=��_"f��_"�X�\�sUL���\=*�|}�R'�F�C�W���ж����y��̿�xV%�*q-�*��x�`�$zS��u+l� Before you go, fill out COVID-19 vaccination forms to make the process smoother. Additionally, those who work in … endstream endobj 85 0 obj <>/Metadata 3 0 R/Pages 82 0 R/StructTreeRoot 9 0 R/Type/Catalog/ViewerPreferences 115 0 R>> endobj 86 0 obj <>/MediaBox[0 0 612 792]/Parent 82 0 R/Resources<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 87 0 obj <>/Subtype/Form/Type/XObject>>stream Cal Lutheran has not yet decided if the COVID-19 vaccine will be added to that list. 5�2ܷ��}�Z�����-��C|�,?t�C�[���9�QGf����▻u�N��#~[�Z�*)�&��[W�{�z�T�;����w������5`t�8r��cG��-�&"���g�唕SVe�ji'������VFAR�\��3'�uijZ�Պ��6���)VN��(V���1K��mC����t���� COVID-19 Vaccine Interest Form If you are unable to get the second vaccine in this time period, the second vaccine can be given at a later time. 1D���)�Yw�������� �)z���� �y�T���s�Riu�}a�J�M��~Xa�����ӣ���v?>hY�'ƌ$�8�h5���Zv���e�q ��\�e�VY��^�Q��ye�. 0.5 0.5 17 17 re H��� Register to get notified when it’s your turn to get the COVID-19 vaccine. �aA�R� People without health insurance can get COVID-19 vaccines at no cost. endstream endobj 96 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream s f COVID-19 vaccines are available at some CVS pharmacies in California for those currently eligible in their county. A doctor or pharmacy may charge a fee for giving the vaccine, but it should be covered by public and private insurance companies. endstream endobj 92 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Vaccine recipients are being asked to complete the form and bring a printout or digital copy to their scheduled appointments, but they also will be allowed to fill it out on-site. endstream endobj 93 0 obj <>/Subtype/Form/Type/XObject>>stream When people do sign up for a vaccine, they don’t have to show much proof, if any. \�` ,u the Louisiana COVID-19 Vaccine Attestation Form which is attached to this Health Alert and will be posted on the Louisiana COVID Vaccination website. My Turn is where Californians can find out if you are eligible for COVID-19 vaccination, schedule appointments, and sign up for notifications. COVID-19 vaccinations in California reach 15 million. 250 0 obj <>/Filter/FlateDecode/ID[<08D2AA98AB6F1842A8AD27520A889AE9>]/Index[219 60]/Info 218 0 R/Length 138/Prev 353937/Root 220 0 R/Size 279/Type/XRef/W[1 3 1]>>stream If you are pregnant regardless of age you are eligible. (Chava Sanchez/LAist) By Jackie Fortiér and Carla Javier. 70)ff� %&>7�����C�SĬA��� �9GLP0 California opened up COVID vaccine appointments for people with underlying health conditions and disabilities on Monday. 0.5 0.5 17 17 re N�k _����u�r��]C M�Bu�����J�C)zָN�Cj9�����H쓹�*M���*�p�]���5�A�s�,�:��6��6�T; n��p{���{4"�>���㱋��}W�}{ώȖޕ��� ں���D�sp�c���t�=j�� 5"�]4�sT�������u;�t�����Kh9��{�"? Jessica Christian/The San Francisco Chronicle/Getty Images The Select Board and administration, along with the Board of Health, is aware that the pandemic has caused stress and anxiety for close to a year now, and that the uncertainty surrounding the vaccine … UPDATE, March 25, 11 a.m.: Gov. %%EOF Once you complete the form and select the “first dose” button, there’s an option to select Johnson & Johnson or Moderna. The self-attestation form will be opened for people in Phase Two once that part of the rollout begins. This California coronavirus vaccine trackers shows how many COVID-19 vaccine doses have been distributed, how CA compares to other U.S. states, and what your place in line is for a shot. California Millions more Californians will be eligible for COVID-19 vaccine. L��{�y������D�0�r�SA�q�SX�Kn��Dž@�y`YxH� �"�� i"y��#B�Q 2��qcУ� ~���w��J!��ܖ�=|�0�g�N���up3�� I�vy�o���� � f6�V��h����TH�:n��q#3����M-D./�s��$��2Q��+uyy�9��� �/H��m�m�? Explore COVID-19 vaccine information and FAQs. County of San Luis Obispo Public Health Department . 1D���)�Yw�������� �)z���� �y�T���s�Riu�}a�J�M��~Xa�����ӣ���v?>hY�'ƌ$�8�h5���Zv���e�q “You can sign a self attestation form, basically saying that you meet the criteria of eligibility. COVID-19 Vaccination Consent Form I have been given a copy of and have read, or have had explained to me, the information contained in the Emergency Use Authorization (EUA) Recipient Fact Sheet for the _____ (brand) COVID-19 vaccine. �@D���)�Yo���lE;a!�.�(X���7̓���訩p���Id�>Y]8��{�x៣ ��y��$�����=����/�K�O�P���c4̸ ��> FDA U.S. Food & Drug Administration, 2/27/21, FDA Issues Emergency Use Authorization for Third COVID-19 Vaccine, Today, the FDA issued an emergency use authorization (EUA) for the third vaccine for the prevention of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This page, COVID-19 Massachusetts Vaccination Attestation Form, is offered by Department of Public Health; show more; COVID-19 Massachusetts Vaccination Attestation Form If you live, work or study in Massachusetts you can use this attestation form to demonstrate you are eligible to receive the vaccine… The pill vaccine aims its ammo at the globe-shaped centre of the virus, which does not often mutate. Additional information provided to assist in preparing for your appointment and next steps after vaccination. endstream endobj 94 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream COVID-19 Vaccine Providers: Providers should have self-attestation forms printed and available for patients who are to be vaccinated by virtue of a qualifying underlying medical condition. While Cedars-Sinai is still experiencing a shortage of doses, the state expects to have enough supplies to vaccinate most Californians … Notice Regarding COVID-19 Vaccine Administration Executive Order N-02-21: Vaccine administration by healing arts licensees. Additional information provided to assist in preparing for your appointment and next steps after vaccination. Special vaccination sites run by Public Health and county, city, and community partners; No one will have to pay for the vaccine. o~ײ�(�LAV g��2�'����[3.��ϯ�؝�'yT������U�� g�O�����U/�ڒS�jC�#���]mWZ4렃���8�X�TL���ܼ�4�A�$��1rZnqi5�}���m�rף���P�MQS��[�|�~���U���3b���ｵ�A'�|�$!4�-�%��_�Y�ԋ����NG�@W����Tݯ��� ��P On April 1, any Californian who is 50 or older will be eligible to receive their COVID-19 vaccination. FRESNO, Calif. (KFSN) -- Eligibility for the COVID-19 vaccine expanded across the state Monday, allowing more people to get their COVID-19 shot. endstream endobj 100 0 obj <>stream California expands vaccine eligibility. California says people need to sign a self-attestation that they meet the criteria for their medical conditions or disabilities to get the coronavirus vaccine. FRESNO COUNTY, Calif. (KGPE) – On Monday, those with certain health conditions and disabilities became eligible to get the COVID-19 vaccine in California. 0.5 0.5 17 17 re If you're having problems using a document with your accessibility tools, please contact us for help . "Ţd�S\0����n��ٻs�+�����2�a^� �)Ŝ;�}�N��f4q~���� �;q��r� p^j�ϴ�X���g�w.w>̋�E��4lYC�`��-�D �!�D�N����4HlR��4�l3Ǎ�n�釃��e!�� �`����Ώ�숙t:��MzL�G���H�Jw8��BȠ�]sB��է>��/ܡnr�\�0r���ȕo�C��ё! 84 0 obj <> endobj COVID-19 vaccination is an important tool to end the COVID-19 pandemic and reopen the economy. s The Fresno County Department of Public Health (FCDPH) is providing the public current information to ensure they are informed on the COVID-19 vaccine. h��X�o�J�W�c�U����TE"�ܢm��!��E|0x�Q���#7�_�gflcI)�v���ל�o��P*A�z�z�>��� �8� �"��� Download COVID-19 vaccination – Consent form for COVID-19 vaccination as Word - 283 KB, 4 pages We aim to provide documents in an accessible format. But you don't have to show extensive paperwork, you don't have to show a doctor's note. endstream endobj 95 0 obj <>/Subtype/Form/Type/XObject>>stream 113 0 obj <>/Filter/FlateDecode/ID[<74EFA9A30CDC1F4594834BB93C1099BA><2D3F4510CB2DED418E35E684B4AF07F9>]/Index[84 69]/Info 83 0 R/Length 123/Prev 121509/Root 85 0 R/Size 153/Type/XRef/W[1 3 1]>>stream 0 0 18 18 re Listing of appointments for COVID-19 Vaccination in the Los Angeles County. If you're having problems using a document with your accessibility tools, please contact us for help . |�3�B#�@�P�`��H�| endstream endobj 99 0 obj <>stream h�bbd```b``v��|`�3�d�f/�L`R,"Yu%��H0� L2����4�u���{`�0yDꛁH�] Ry#�d���LD2��H~�K@�5�`W1��G����;������a`��&�g F�� Vaccines are going to people in phases. See groups vaccinating now. /���5�L� CONSENT FORM –COVID-19 Vaccine . Vaccinations are prioritized according to risk and age. The state of California has signed a new Third Party Administrator (TPA) contract with Blue Shield of California to help the state optimize and accelerate COVID-19 vaccine allocation and distribution equitably, efficiently, and safely throughout the state. H��� COVID-19 Massachusetts Vaccination Attestation Form If you live, work or study in Massachusetts you can use this attestation form to demonstrate you are eligible to receive the vaccine. Once you are vaccinated, your vaccine will be entered into the State of California vaccination data base known as CAIR. COVID-19 vaccine Fresno County to open 5 new vaccine clinics in rural areas this month The new vaccine clinics will be in Sanger, Kerman, Selma, Mendota, and Fresno City College. f The Town of Grafton has received many calls relating to the availability of the COVID-19 vaccine. Cal Lutheran has not yet decided if the COVID-19 vaccine will be added to that list. endstream endobj 88 0 obj <>/Subtype/Form/Type/XObject>>stream >r�uZ��V`��Z6F������@7��L���_nj�mf�>}���h�-G�ai����;r8�u�ѻ�ѿ�&. In California, Gov. Please fill out this form to confirm your eligibility to receive a COVID-19 vaccination in the current prioritization phase. 278 0 obj <>stream Soon all adults over 16 will be eligible to get the COVID-19 vaccine in California, but how can you sign up? �d�0`��6J$�����W$}��oj^N��p1)z8 ��A9�=�)�Z���F�/U���F����� ���Yi��� �1P"{!x��@��H���#Q|�uZ�}����[em,;W>����m�#)!��l/��a?2O�|a��hȏ�4VO%��u ��b�B� �](du����x��������L����zBzd����P����/��#�)%wS����Wj�]eO�Dp�6�f1�BϢ��&�v+�ƌu�F�H��.B�Y�!���[EO��� ���;=��6� k�n�����=���E�o���lX��6�D��]��~17J����KX�\!�|m>*�\��9('wnb8���_&�2��@�� ��F'�-.VC�e�ۮgY�yl)n ��(��~���F�����bl�R��n� Please enable JavaScript to view the page content. A pharmacist at UCI Health holds a dose of the COVID-19 vaccine. Listing of appointments for COVID-19 Vaccination in the Los Angeles County. Fresno Co. vaccination clinics require a doctor's note, but if you can't get one, you can fill out a Self-Attestation Form. This page, COVID-19 Massachusetts Vaccination Attestation Form, is offered by Department of Public Health; show more; COVID-19 Massachusetts Vaccination Attestation Form If you live, work or study in Massachusetts you can use this attestation form to demonstrate you are eligible to receive the vaccine… H��UMo�0��W�h�"9�mAMz�b`l�n\��X�����YҐH��m�|$e*S�#��� �� ��[ RI�@[D��DQ!��T�� Check your COVID-19 vaccine eligibility status, book a vaccine appointment, or sign up for eligibility alerts. Newsom announced California is expanding COVID-19 vaccine eligibility to everyone 50 and older starting April 1. The TPA will be working closely with local health departments to identify facilities that have the capacity to properly maintain COVID-19 vaccine and … 0 0 18 18 re \�` ,u Health experts widely believe the benefits of the vaccine outweigh the risks of a potential reaction or flare-up, since immunocompromised people have an increased risk of a severe form of COVID … Pregnancy and COVID vaccine ... expect to be asked to sign a “self-attestation” that you meet the criteria. COVID-19 vaccine supply is limited, and is subject to prioritized phases as recommended by the Massachusetts COVID-19 Advisory Group. Information on access to COVID-19 vaccine access in Snohomish County. 62����9����j.�fb`�nҌl=%-s�� �2� Healthcare workers and long-term care residents (Phase 1A) For more information on how and where these patients can access vaccine, please California’s COVID-19 webpage . The California Department of Public Health specifies that people with certain health conditions, "deemed to be at the very highest risk for morbidity and mortality from COVID-19," qualify for vaccine … State of Louisiana COVID-19 Vaccination Medical Risk Factor Self-Attestation Form Effective Tuesday, March 9 th 2021, the State of Louisiana has expanded eligibility for COVID-19 Vaccines to include people who have health conditions that may result in a higher risk of disease. However, there are many gray areas. Before a vaccine became available, Newsom promised that equity would be a priority in vaccine distribution. H��TMS�0��W����%˲5�0C �~�P�iC�������++���mƹd6+�۷ﭕ��j9�'�JU�z��l��.��ܫ���˺��-$������J-������ O�O��Q�T��]4���3J!N(�B[G_��*�(�2r�⼄��Y�@�xrY��(Ą&4�����XF�� /$�u�f����K�K If you're having problems using a document with your accessibility tools, please contact us for help . �_�^��s�{�z��U��� +8�a��u� Instead, you will be asked to sign a “self-attestation” form confirming your eligibility, available here in English and Spanish. f����r���O��� ���Bߛ�L�]H�+_�w�l��Ef�=�!P�����h������ y��="�NS�5�=�s?�#�db�кz��G�5���5��v�:t�q��>� ��O���� E�ń�����.&�L\�p��b4�a!�a��u�ST|R�mޜ� �`� B���#S>a��R:��nהz�b���y~sM���s�4C#8����d� Z��B���H�h� SO8aJ�^`���f/�T��u��� Ā ����xg/��7j6�̙4[B�O��[�����������i�#8;��C��36DxdC������=pkn�(�=�-�tb4��M�>������׀�Y�O�|�h:��N 6� �����E~�'=�}��+0�Z=负����(�WQ��tG����"�� Before starting their first semester, all California Lutheran University undergraduate students are required to complete Health Services’ online health forms, which include proof of four vaccines. Brookline recently re-activated its COVID-19 call center (617-879-5636) to answer vaccine questions, and as of Tuesday, Health Commissioner Dr. Swannie Jett … EMC Soon all adults over 16 will be eligible to get the COVID-19 vaccine in California, but how can you sign up? You can get a vaccine … On Monday, Californians age 16 to 64 with underlying conditions can receive the coronavirus vaccine, adding 4.4 million people to the list of eligible folks. Southern California is speeding up rollout of the COVID-19 vaccine. f Published: January 11, 2021, 1:58 am Updated: January 11, 2021, 2:08 am. A drive-through COVID-19 testing site is set up by the Los Angeles Fire Department (LAFD) outside The Forum, in Inglewood, California, on April 27, 2020 amid the novel coronavirus pandemic. Vaccination is one of the most important tools against the COVID-19 pandemic and the emergence of new strains. s COVID-19 VACCINE SCREENING FORM 2020-2021 . %%EOF Local News. COVID-19 VACCINE SCREENING FORM 2020-2021 . 219 0 obj <> endobj State of Louisiana COVID-19 Vaccination Medical Risk Factor Self-Attestation Form Effective Monday, ... you are now eligible to receive COVID-19 vaccine. But they face obstacles People arrive this week at a new vaccine site at USC meant to … 2191 Johnson Ave, San Luis Obispo, CA 93401 Phone: 805-781-5500 | Fax: 805-781-5543 | www.slopublichealth.org . (Check back as we will continue to add more of these forms from hospitals in South Florida that are administering the COVID-19 vaccine.) endstream endobj 90 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Californians at higher risk from COVID-19 are eligible for vaccination now sign a self-attestation that they meet the criteria for high-risk medical conditions or disabilities. FRESNO COUNTY, Calif. (KSEE) – On Monday, those with certain health conditions and disabilities became eligible to get the COVID-19 vaccine in California. %PDF-1.7 %���� COVID-19 Vaccine Consent Form . The total number of COVID-19 vaccinations administered in California has reached 15 million. 1 g Questions and Answers. 0 s 23% of all Californians have received at least one dose of the COVID-19 vaccine, and the rollout is expanding to reach new populations. Moderna COVID-19 Vaccine Screening and Consent Form … Vaccine supplies are limited everywhere and available only to those now eligible under each state’s phased plan . 0.5 0.5 17 17 re Self-Attestation for Eligible category signed on app. Dr Soon-Shiong says the value of ImmunityBio's vaccine is that it generates "killer T cells" that target the centre of the coronavirus, which is less prone to mutation. 0.75293 g H��� Download COVID-19 vaccination – Consent form as Word - 283 KB, 4 pages We aim to provide documents in an accessible format. Becker’s Hospital Review, 2/23/21, 3 Reasons COVId-19 Vaccines Remain in Short Supply, Though the U.S. has invested billions of dollars in COVID-19 vaccine manufacturing and invoked the Defense Production Act to boost supplies needed to make the vaccines, there are still not enough doses to meet demand, Kaiser Health News reported Feb. 23. Vaccine Information, Privacy Practices, and Self-Attestation. Starting March 15, Californians who are 16-to-64 years old with disabilities and certain high-risk health conditions can sign up for a free COVID-19 vaccine. endstream endobj 220 0 obj <>/Metadata 16 0 R/PageLayout/OneColumn/Pages 217 0 R/StructTreeRoot 42 0 R/Type/Catalog/ViewerPreferences<>>> endobj 221 0 obj <> endobj 222 0 obj <>stream Who is eligible next? 0.75293 g Acknowledgment of . This is where counties stand on their distribution plans. COVID-19 vaccine supply is limited, and is subject to prioritized phases as recommended by the Massachusetts COVID … The EUA allows the Janssen COVID-19 Vaccine to be distributed in the … H��� COVID-19 HIGH RISK SELF ATTESTATION FORM This form must be completed if you are between the ages of 16-64 and deemed to be at the very highest risk to get very sick from COVID-19 due to one or more of the qualifying severe health conditions (listed below) • Cancer, current with weakened immune system • Chronic kidney disease, stage 4 or above ؔP�y���1r1W0�1�0u3�f���˸������I�F�rL���|����X�yz���>�%�[� Ad. }S��Q�=,FC�0���N˵�����i�^:zB��Q��)�I ��z#�U�sB������C�j�oԭ�~^]�0�#�K��_��@W�n��0辄���f]#�bzB;���p��c�T��1m�\���v"��e���� [fŖ˜3Xg�U��9�%�fT�Wз�E�p Ն�9&lk�_��=y�lKD,��E?o�V���n^Ǣ���CY�� qcϚ �@D���)�Yo���lE;a!�.�(X���7̓���訩p���Id�>Y]8��{�x៣ ��y��$�����=����/�K�O�P���c4̸ ��> Oral COVID-19 vaccine being tested in LA-area research center What's behind the push for a fourth stimulus check California to reopen June 15 if state meets specific criteria California is allocating COVID-19 vaccines as they become available to ensure equitable distribution. Anyone wishing to receive COVID vaccine must meet the minimum age requirement and show proof of age at the time of appointment. Mass.gov has additional clarification about each prioritization category. ,&/�Iw0y��,g�3 �s���L���`���� f�ٓA��s��� rC8Xv�d�ےtH���e`��-�F�aK�g`zt � �� endstream endobj startxref The self-attestation form will be opened for people in Phase Two once that part of the rollout begins. /Tx BMC endstream endobj 97 0 obj <>stream Includes information on eligibility, vaccine types, available registration systems and unique registration links that have been made available. COVID-19 Vaccine Update for Patients. But those on the frontlines of ensuring that the vaccine gets to those most impacted say it hasn’t worked out that way. COVID-19 VACCINE SCREENING FORM 2020-2021 County of San Luis Obispo Public Health Department 2191 Johnson Ave, San Luis Obispo, CA 93401 Phone: 805-781-5500 | Fax: 805-781-5543 | www.slopublichealth.org No Medical Evaluation By: Administered By: Injection Site: Print Name Print Name [Affix Label Here] Weight (lbs): Phone: Gender: Male Female Decline to state American Indian … Because COVID-19 is a new disease with new vaccines, you may have questions about what happens before, during, and after you are vaccinated. Your support ID is: 10763827058956635915. endstream endobj startxref See CDPH’s . Alameda County workers line up to receive coronavirus vaccines outside St. Rose Hospital in Hayward, California on January 8, 2021. Tags: Florida, COVID … Additionally, those who work in … %PDF-1.7 %���� 9 min ���ﬨ avS�^;��U��Nϱ�Ŧ���\�:I"uo���uT̫�:$�a�UE9h��U�,� Before starting their first semester, all California Lutheran University undergraduate students are required to complete Health Services’ online health forms, which include proof of four vaccines. See vaccination statistics statewide and broken down by county in our Vaccine Dashboard. Check the state's COVID-19 vaccine website for more information or call California's COVID-19 hotline at 833-422-4255. … But it’s confusing, and some people may cut the line. I have had an opportunity to ask questions which were answered to my satisfaction. endstream endobj 89 0 obj <>/Subtype/Form/Type/XObject>>stream Download COVID-19 vaccination – Consent form as Word - 283 KB, 4 pages We aim to provide documents in an accessible format. endstream endobj 98 0 obj <>stream h�bbd```b``���A$�jɸ �7�K��A�#4E�ُ���,fY�S& ��}8U�1|%A���ܘ��`D�³=�#|M!ܒ�y;��-֎&�]t/�@�#�ܚ\`c�6��AL Ǹ/=�wbj����ȯ��;�IDG��>Xn/����%�+�7�����Q�z{�~�kSc��%hg�3sb ݜ��Q�ν!��\�eENr�����s�g���^[��k��Eܒ�QWɲB(��D�����V���N�hm������ю����y&���j�gH{��I��o�e q���2���tr�t�C@��Gy�%C2�� H��UQo�0~�W�#��6��I�mR�NC�CTUX�51����w4`�M���9������cq2Oz7�����1`q�P����ԛ�)�)!��ł2������[�"��QW��ݐIH��9� �O��,�*�����ba���pA�J�/3�EMI����oX؆��PN��9s��P4�n xw !��U��Wi�j(�}I:ta24���S��������f��ŧ%�������k!�mL�,CI�mj6F���_�J�^4�7-�g��a��=M$Kueە'���*��t�*�j��0n1 b�Ǹ^g�.�L:OԙnH� pk)���4ζDŽ� �4�$4N����w뜫���m���b���F��x��JCxK0��˰�#:��Fa�a�7m��Lz���Y��:0�6�wƑۍ�ܝP[p��xB�j3UV�]/��\UY���K�e%��Tq�� endstream endobj 91 0 obj <>/Subtype/Form/Type/XObject>>stream Alameda Vaccine: Register For Alameda County Notification - Alameda, CA - The county has released an online form for residents to fill out: "We will notify you when a vaccine is available." /Tx BMC h�b```"3V�l!��1�0p\`�y��A&�[���(Y& ���9��-�4T���ѵ�"�����������H�� I self-attest that I meet current eligibility requirements: 3/26/21 Self-attestation (English) Los Angeles County COVID-19 VACCINE ELIGIBILITY: Self-Attestation I attest that (check only one box): I have a medical condition or disability that makes me eligible for the COVID-19 vaccine I am experiencing homelessness in Los Angeles County and currently stay in a … 0 Vaccine recipients are being asked to complete the form and bring a printout or digital copy to their scheduled appointments, but they also will be allowed to fill it out on-site. CHC/SEK says its representatives will contact you to schedule a date for the vaccine. The two COVID-19 vaccinations available now are both two-shot vaccines, with the second vaccine given 21-28 days after the first.
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