Please note that the current vaccine availability of the Moderna COVID-19 vaccine is limited. This form will be used for initial registration and pre-screening for vaccination eligibility at UITCT. UITCT is following IHS, CDC, and state guidelines for the administration of the vaccine. Registrants will be contacted with the next steps to schedule a vaccine appointment based on selected availability. It is important that you double-check the contact information in this section so that we will be able to reach you.
TO BE ELIGIBLE TO RECEIVE THE VACCINE FROM UITCT, YOU MUST MEET THE FOLLOWING CRITERIA:
You are an active patient at UITCT (Seen within the last 3 years) over the age of 18; or
You are an American Indian/Alaska Native enrolled in a Federally or State Recognized Tribe with Tribal Documentation over the age of 18; or
You are an adult Non-Native household member an American Indian/ Alaskan Native.