Vaccine Information

COVID-19 Vaccination Forms

Individuals scheduled to receive a COVID-19 vaccination should fill out the Consent Form for the vaccine to be given and bring the completed form to your scheduled appointment.

Please note, if you currently have COVID-19, have received antibody therapy for COVID-19 within the last 90 days, or have received any other vaccine(s) in the two-week period before your appointment, you will need to reschedule.


Moderna Consent Form – English

Moderna Fact Sheet -English

Formulario de consentimiento de Moderna – Español

Hoja informativa de Moderna – Español

VSAFE Information Sheet – English

Hoja de información de VSAFE – Español

Johnson & Johnson:

Johnson & Johnson Consent Form – English

Johnson & Johnson Fact Sheet – English

Formulario de consentimiento de Johnson & Johnson – Español

Hoja de datos de Johnson & Johnson – Español


Pfizer Fact Sheet – English

Pfizer Consent Form – English

Hoja informativa de Pfizer – Español

Formulario de consentimiento de Pfizer – Español

COVID-19 Vaccine Information 

PHS is now offering all three CDC-approved vaccines; Moderna, Johnson & Johnson, and Pfizer.

Beginning June 8, 2021 
Walk-In Covid Vaccine Clinics at PHS
Every Tuesday from 10 a.m. to 12 p.m.
No appointment necessary.

Questions about the COVID-19 vaccines?

Visit the CDC website here to learn more.

Looking to get a COVID-19 Vaccine?

The PHS District offers multiple locations for individuals to receive a Covid-19 vaccination. To find a convenient location near you, check out our resource guide!

Download the COVID-19 Vaccine resource sheet

To view the Nebraska DHHS vaccine information page, click here.

Updated CDC Guidance for Fully Vaccinated Individuals