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COVID-19 Vaccine Paperwork

If you will be coming to a Liberty Doctors COVID-19 Vaccine Clinic, completing your paperwork ahead of time can expedite the vaccination process.

For all recipients:

  • COVID Vaccine Encounter Form
  • Prevaccination Questionnaire

If recipient is aged 18 or younger:

  • Consent Form

If recipient is a new patient or has not been to a Liberty Doctors office within the last two years:

  • Liberty Doctors patient registration 

 

CDC Pfizer Vaccine Overview and Safety

Every Liberty Doctors Location is PCMH certified!

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