COVID-19 Booster Sign-up - Memorial Hospital, Carthage IL

Booster shots for recipients of the COVID-19 vaccine are available from Memorial Hospital clinics. Patients wishing to receive a COVID-19 booster must be five months since their second dose and must meet the following criteria:

12 years or older

Recipients MUST bring proof of previous COVID-19 vaccination (i.e., vaccination card).

Vaccine Booster Sign-up

First Name

Last Name

Phone

Address

City

State/Province

Zip/Postal

Country

Date of Birth

Date of last COVID Vaccine

Type of past COVID Vaccine

Your Medical Provider's Name

Please list any chronic health conditions here:

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