If you are a current JMHS patient and/or a resident of Minnesota, please fill out the form below to be added to our waiting list. Please note at this time we are only allowed to give COVID-19 Vaccines to State residents. Waiting List Name* First Last Date of Birth* Please use this format: mm/dd/yyyyAge* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email Booster ShotsThe CDC is recommending an additional dose of mRNA COVID-19 vaccine when the immune response following the two-dose primary series is likely to be insufficient. This is recommended for moderately to severely immunocompromised people or adults over 65 years old. If you are wanting a Booster shot, please list what COVID-19 Vaccine you were previously given. Booster Pfizer Moderna* Johnson & Johnson* *Waiting for approvalNameThis field is for validation purposes and should be left unchanged. Δ
