Registration Instructions

Before starting the registration process, please ensure that you meet all the following Eligibility Criteria:
  • Individuals getting vaccinated at the Beachside Site must:
    • Be a Florida Resident (and be able to prove residency).
    • Be at least 18 years of age (and be able to prove age).
    • Not have been infected with  COVID-19 within the last 90 days.
    • Not have received any other vaccinations within the last 14 days.
    • Not carry an epi-pen for treatment of anaphylaxis.
    • Not have had a severe allergic reaction to any ingredient in the Moderna vaccine.
    • Not have received a previous dose of COVID-19 vaccine.


Step 1) Review the Moderna What to Expect, Fact Sheet, Privacy Practices and V-Safe Instruction documents below.

Step 2) Print out and complete the COVID-19 Screening and Consent Form and Vaccine Recipient Checklist documents below.                                ***IMPORTANT: You will need to print and bring these forms with you to your appointment.***

Step 3) Select the pair of dates below that will work best for your 1st & 2nd doses.                                                                                                         ***IMPORTANT: You must be available for both the initial vaccination (1st date) and follow up vaccination (2nd date)***

Step 4) Follow instructions on the next page to book your appointment time.

If you have any questions or concerns with the registration process, please call (321)724-1736 and press 0 to leave a voicemail with your name, the issue you are having, and your call back number.


1. View These Documents

2. Print & Complete These Documents

* You must print and bring a completed copy of these forms with you to your appointment! *

3. Pick Your 1st & 2nd Dose Date

* You MUST be available for BOTH the 1st & 2nd shot date chosen below *


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