To
use this system, you must have an email address.
•
NOTE:
pre-registering does not guarantee that someone will get
vaccinated
•
Who can get the H1N1 nasal spray vaccine?
Nasal spray vaccine is appropriate for healthy people ages
2-49 years old who are not pregnant.
Who should NOT
get the nasal spray vaccine?
Print vaccine consent form- If you cannot
pre-register on the Ohio Department of Health site, you may
print this form and complete it with a pen and take it with
you when you go to receive the vaccine. You do NOT need additional
paperwork if you pre-register on the Ohio Department of
Health website.
•
NOTE: if you pre-register on the Ohio Department of Health
website, you do not need to complete this form. Just
bring your paperwork from the pre-registration site.
