COVID-19 Vaccination Consent & Registration Forms

To save time at vaccination clinics operated by the City of Middletown, you may print and bring the forms with you. If you do not have access to a printer, forms are available at clinics. 

Note: Children 12-17 years of age are only eligible to receive the Pfizer/BioNTech vaccine at this time. Children ages 12-17 must also be accompanied by a parent/guardian for the duration of their appointment. Parents/guardians are encouraged to call ahead and schedule an appointment with the clinic.