Screen Reader Mode Icon

Veteran Vaccine Sign-up List

Please fill out this form to sign-up to receive a FREE flu and qualified insurance accepted COVID or RSV vaccines at the Stamford Veterans Resource Center located on the second floor at Old Town Hall (175 Atlantic Street, Stamford, CT 06902) on Thursday, February 15, 2024 anytime from 10:30 AM - 12:30 PM.  Photo identification is needed for all vaccines.  Proof of insurance is needed for COVID or RSV vaccines (Please note, TRICARE Insurance is not accepted.)

Question Title

* 1. Please tell us your first and last name as it reads on your photo identification.

Question Title

* 2. Please tell us your age.

Question Title

* 3. Please check all vaccinations you wish to get during your visit.

0 of 3 answered