High School Student Covid Vaccine Sign-up

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The major hospital systems in our area would like to invite teens ages 16 and above to get vaccinated against COVID-19. To assist in that effort, metro-area school districts are coordinating group appointments and transportation options. David Douglas High School and Fir Ridge Campus are participating in this venture.

Students will receive the Pfizer vaccine, as it is the only one currently approved for this age group. Since the Pfizer vaccine is a two shot sequence, students will be given a second appointment time for approximately three weeks after May 7th. District transportation will be provided for this appointment, as well.

Please make a note that students will meet at the High School North Building by the flagpole to catch their bus. Students should show up 15 minutes prior to the Bus Departing Time.

Additional information from Oregon Health Authority:

https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le3682.pdf

What to bring to the vaccine appointment?

Students will need to bring photo ID and insurance information if they have it

Preparing for the vaccine appointment:

Dress comfortably in clothing that makes it easy to expose your upper arm. The clinic will be outdoors so dress appropriately for the weather. You can expect to have some waiting time, including an observation period of up to 30 minutes after your vaccination.

Will There be a cost for the vaccine?

There will be no cost for the vaccine.

Is more than one injection needed?

The Pfizer vaccine use 2 shots, which are given several weeks apart. The first shot primes the immune system, helping it recognize the virus, and the second shot strengthens the immune response.

When will youth and children under age 16 become eligible?

Currently no vaccine has been authorized for people under the age of 16. Pfizer recently applied for authorization for their vaccine to be administered to people 12 and older. It is possible that by mid-summer, people age 12 and up would be able to be vaccinated with the Pfizer vaccine.

Student Information and Preferred Time Slot

Student's School: *

Student ID/Lunch number: *

Student's First Name: *

Students Last Name: *

Student's Date of Birth: *

YYYY

To sign-up your student for the Pfizer Covid Vaccine on Friday May 7th, 2021 please select your preferred time. *

Please make a note that students will meet at the High School North Building by the flagpole to catch their bus. Students should show up 15 minutes prior to the Bus Departing Time

8:40am - Bus Leaves DDHS / 9:20am - Arrive at the Convention Center

9:20am - Bus Leaves DDHS / 10:00am - Arrive at the Convention Center

10:00am - Bus Leaves DDHS / 10:40am - Arrive at the Convention Center

10:40am - Bus Leaves DDHS / 11:20am - Arrive at the Convention Center

11:20am - Bus Leaves DDHS / 12:00pm - Arrive at the Convention Center

12:00am - Bus Leaves DDHS / 12:40pm - Arrive at the Convention Center

Parent/Guardian Information and Permission

Family/Guardian First Name: *

Family/Guardian Last Name : *

Email that you use most frequently:

Family/Guardian Phone Number: *

Family / Guardian Permission *

By providing your name and submitting this form, you give permission for your student to get the Pfizer vaccine at the David Douglas High School location.

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