CHNY COVID-19 Immunization Screening & Consent Form
The information you provide will be seen by Covenant House New York Health Center staff. Please note that the Moderna vaccine, which is the only vaccine available at the Covenant House New York Health Center, is approved only for those 18 years of age and older. Patients who are 16 and 17 years of age should look for appointments elsewhere that offer the Pfizer vaccine, which is approved for those 16 and older. At this time, CHNY is unable to offer vaccines to those who are under 18.