Covid Vaccine Registration

Please make sure you follow the instructions below to expedite your requested service at Spectrum Healthcare.

Covid vaccines are only administered on select days in accordance with the phased populations as set forth by AZ Department Health Services. Please refer to our covid vaccine page here for more details.

Please note, you are attesting to the following by requesting an online appointment and checking in at one of our facilities for a covid vaccine:

ATTESTATIONS

Statement 1: I am 18 years of age or older. The Moderna or JnJ vaccine administered by Spectrum Healthcare is only authorized for use in individuals 18 or older.
Statement 2: I have read or have had explained to me the information contained in the Vaccine Information Statements (VISs) about the following disease(s) and vaccine(s): Covid-19. I will have a chance to ask questions that will be answered to my satisfaction before receiving a vaccination. I understand the benefits and risks of the vaccine(s) and request that the vaccine(s) indicated by my requested appointment be given to me or the person named on the patient registration for who I am authorized to make this request.
Statement 3: I agree to allow the health care provider giving vaccinations to release information about all vaccinations given to me, or to the person for who I am authorized to consent, to the Arizona State Immunization Information System (ASIIS), other health care providers and schools in order to avoid receiving unnecessary vaccinations and to provide information about what immunizations have been received. I understand that I am not required to agree to the release of this information in order to receive the vaccinations I request.
If I do not wish this record to be included in ASIIS, I have the option of making this request to the vaccine administrator. I understand that by making this decision, I will not have access to my immunization records (in ASIIS) in the future for schools, college attendance, future jobs/employment, military, etc.
 
I attest that I have read Spectrum Healthcare’s notice of privacy practices by clicking HERE
I attest that I have read the Health Current notice of health information practices by clicking HERE

 

You can also schedule using your existing patient portal account. From your portal account, you can click on Appointments at the top to begin your appointment request.

For more information about the COVID-19 vaccine please check out the following resources:

CDC: https://www.cdc.gov/vaccines/covid-19/info-by-product/moderna/index.html

FDA EAU Fact Sheet: https://www.fda.gov/media/144638/download

Contact us

Call Us

(877) 634-7333

Crisis Line

877-634-7333

Responder 1st

Get in touch