5/27 - 5/28 St. Louis City Vaccination Events Staffing Request

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Friday (5/27)
Location: Forest Park Vaccine Clinic & Community Outreach, 1 Theatre Dr, St. Louis, MO 63112
Vaccine: Pfizer (5<12) & Pfizer (12+)
Event Time: 10:00 A.M. to 3:00 P.M.
Staffing Need: One medical volunteer, three support volunteers

Saturday (5/28)
Location: Kennerly Temple Church Vaccine Clinic, 4307 Kennerly Ave, St. Louis, MO 63113
Vaccine: Pfizer (5<12) & Pfizer (12+)
Event Time: 10:00 A.M. to 2:00 P.M.
Staffing Need: three medical volunteers, five volunteers

Event details will be distributed to selected volunteers by the day prior to each event. Volunteer positions are filled as form submissions are received. If you have any questions, please contact Scott C. Geary at (808) 375-4596 or gearys@stlouis-mo.gov.

Full Name *

Email Address *

Phone Number *

5/27 - Forest Park Vaccine Clinic & Community Outreach, 1 Theatre Dr, St. Louis, MO 63112

Shift: 10:00 AM to 3:00 PM

Not Available

Clear selection

5/28 - Kennerly Temple Church Vaccine Clinic, 4307 Kennerly Ave, St. Louis, MO 63113

Shift: 10:00 AM to 2:00 PM

Not Available

Clear selection

I acknowledge there is no guarantee of filling volunteer position preferences. If possible, I would prefer to assist with... *

Greeting - Management of entrance doors, temperature checks, direct to next station

Consent Form Distribution - Prepare, distribute, and sanitize clipboards and writing utensils

Flow Control - Direct individuals to next station, ensure appropriate social distancing and organized crowd flow

Functional and Access Needs - Assist individuals with functional and access needs through the Screening process if necessary, assist individuals with completion of consent forms

Observation Area - Review vaccination cards, distribute educational material, monitor for any initial adverse reactions

Vaccination Staff (12+)- Administer vaccine to individuals aged 12+ or act as scribe; MD & RN students must have faculty present from their school to administer vaccine

Vaccination Staff (5<12)- Administer vaccine to individuals aged 5<12 or act as scribe; MD & RN students must have faculty present from their school to administer vaccine

Required

Please share any information that is important for the staffing team to be aware of when scheduling you for these events:

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of City of Saint Louis. Report Abuse

Forms