New HHS student COVID-19 vaccination record 5.10.21
Parents: Starting May 14th, 2021 students residing in N.H. and VT. and are 12+ years old may register for a date to receive  a COVID vaccination.  Once your child has received their vaccination, please complete the form, below, and submit it. If they receive a 2-shot series, please complete this form a second time once the 2nd shot has been given. Completed shots only; not shots pending. Thank you!  
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Student last name *
Student first name *
Date of COVID-19 vaccination #1 *
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DD
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YYYY
Date of COVID-19 vaccination #2  (when completed)
MM
/
DD
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YYYY
Vaccination type *
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