Youth Vaccine Event

Native American Community Clinic (NACC) is partnering with MIWRC, Red Lake Nation and M-Health Fairview to provide the COVID-19 vaccine to Native American Youth, Friends and Family.

2-shot Pfizer vaccine open to all community members 16+ (those 12+ are encourged to sign up, we will open the event up to this age group if FDA approval comes next week as expected)
Those under 18 will need parental consent.
The vaccine event will be held in the old Dollar Tree Space at 1221 East Franklin Ave (next to the Aldi)
First shot: May 22nd between 10am-2pm
Second shot: June 12 between 10am-2pm

For information on the Pfizer vaccine potential risks and side effects, please visit the CDC website.

After you fill out this form, we will reach out to you by phone to get you scheduled for a vaccine timeslot.

Your Name*

First NameLast Name

Your Birthdate*

MonthDayYear

Your Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Gender*

FemaleMaleOther

Race (Choose all the apply):*

Ethnicity*

Hispanic/LatinoNot Hispanic/LatinoOther or UndeterminedChoose Not to Disclose

NACC COVID-19 Youth Vaccination Event Registration Form

After you fill out this form, we will reach out to you by phone to get you scheduled for a vaccine timeslot.