COVID-19 Vaccine Information & Intake Form

COVID-19 Vaccine by Appointment Only

Currently, we are only offering the Moderna Vaccine. Due to limited availability, our office will call you directly to schedule. Please do not call or email the office. We cannot accommodate any Walk-Ins.

Moderna Vaccine Information Link

As of March 25th, 2021, all Georgians aged 16 and older are eligible to be vaccinated. Currently, our facility can only administer to Georgians aged 18 and older.

DPH Vaccine Eligibility Link

Additional Criteria for Vaccine Eligibility

  • You never had any life-threatening allergic reaction after dose of any vaccine or injectable medication.
  • You have not had any vaccine within the past 14 days and will not receive another vaccine within the next 14 days.
  • You are not currently under isolation or have not been exposed to someone with COVID-19.
  • You are not currently moderately or severely sick.
  • You have not received monoclonal antibody therapy or convalescent plasma for COVID-19 treatment in the past 90 days.
  • You do not have a severe, potentially life-threatening, allergy to any component of this vaccine as detailed in the Emergency Use Authorization.
  • You are 18 years of age or older.
  • You currently live and/or work in Georgia.

Day of Vaccination

  • Please wear loose clothing so the shoulder area is easily accessible for the injection.
  • Our facility has limited parking spaces and is practicing social distancing protocols. Please do not arrive earlier than 10 minutes of your appointment time.
  • Vaccine check in area will be to your left once you enter.
  • Please have a Georgia issued ID. If you are currently not a Georgia resident, please have proof of employment. If you are insured, you must provide your health insurance information. If you are uninsured, we will ask for your Social Security Number. The federal government is providing the vaccine FREE of charge to all people living in the United States, regardless of immigration or health insurance status. We, the administrators, can seek reimbursement from your health plan or program, per the CDC.

HHS COVID-19 Vaccine Fact Sheet Link

  • After vaccination, you will be directed to the waiting area for a self-timed 15-minute observation. You may leave after 15 minutes if you do not experience any side-effects.
  • If you are sick the day of or COVID-19 positive within 14 days of your scheduled appointment, contact us to reschedule.
  • If this is your second appointment: Please follow the above steps and have your vaccination record card.


  • We encourage everyone to sign up for health checker to report any symptoms experienced post vaccination.

V-Safe Self Reporting Link