COVID-19 IMMUNIZATION SIGN UP - READ CAREFULLY

Harrington HealthCare System is currently offering vaccination for all those who qualify for vaccination under

Phase 1

Phase 2/Group 1 includes all those 75 and older

Phase 2/Group 2 includes:
Adults 65 and over
Adults who live or work in public and private low income and affordable senior housing
People with 2 or more certain medical conditions that cause individuals to be at an increased risk of severe
illness from COVID-19:
-Asthma (moderate-to-severe)*
-Cancer
-Chronic kidney disease
-COPD (chronic obstructive pulmonary disease)
-Down Syndrome
-Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
-Immunocompromised state (weakened immune system) from solid organ transplant
-Obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2)
-Severe Obesity (BMI ≥ 40 kg/m2)
-Pregnancy
-Sickle cell disease
-Smoking
-Type 2 diabetes mellitus

Please refer to https://www.mass.gov/covid-19-vaccine-in-massachusetts for more details

***You must qualify under Phase 1 or Phase 2/Groups 1 or 2 to be eligible for vaccination, no exceptions.

***At your appointment, you may be asked for the following information:

Insurance card. Vaccination is free whether you have insurance or not, if you have insurance, please bring that information with you.

Identification, examples include:
-Employer-issued ID card that includes your name and title; or
-Government-issues identification or license; or
-Recent pay stub

You may get a vaccination even if you do not have a driver’s license of social security number

***Visit this link to ensure you qualify for vaccination under Phase 1or Phase 2/Groups 1 or 2 of the COVID-19 Vaccine Distribution Timeline https://www.mass.gov/info-details/covid-19-vaccine-distribution-timeline-phase-overview#phase-1-

***This is for initial immunization sign-up only. If you have already received the initial vaccine you would have been given your return appointment. An appointment reminder for your 2nd vaccine dose will be sent via call/text message to your phone number on file.***

***For those who have a history of anaphylactic reactions, please contact the vaccination center at 508-765-8160, as your visit may need to be vaccinated in a hospital setting.

***Vaccination is only offered to those 18 years of age and older

***Vaccination Center Location: Southbridge Community Center - 153 Chestnut St, Southbridge MA. 01550


Select which criteria in Phase 1 or Phase 2, Step1 that qualifies you for vaccination: More detailed descriptions available here: https://www.mass.gov/info-details/covid-19-vaccine-distribution-timeline-phase-overview#phase-1- *
Required
If you qualify based on medical conditions, please specify two or more certain medical conditions that cause you to be at risk for severe illness. For more info visit: https://www.mass.gov/info-details/covid-19-vaccinations-for-individuals-with-certain-medical-conditions
Occupation - skip if 75 or older
Please describe your specific job function that qualifies you under Phase 1:
Name and Town of Employer - skip if 75 or older
Please list your employer and town. Vaccination staff may verify your employment.
Employer Telephone Number - skip if 75 or older
Employment Status - skip if 75 or older
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