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  • English (US)
  • COVID-19 Vaccine Clinic Registration

    Please fill out the below questionnaire to be put on the list for the New Milford Borough COVID-19 Vaccine Clinic. You will be contacted at a later time to schedule the date and time of your vaccination.
  • Basic Demographics

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  • Employment/Volunteer Information

  • Health/Medical Information

  • Allergic Reactions

    The following section is asking about severe allergic reactions [e.g., anaphylaxis] that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
  • COVID-19 Specific Information

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    Pick a Date
  • There is a potential for last minute appointment availability. Would you be interested in and able to get to the New Milford Senior Center (275 River Rd, New Milford, NJ 07646) within 15 minutes of receiving notification? DO NOT COME TO THE SENIOR CENTER UNLESS YOU ARE CALLED. We would be looking for people to who are available on Wednesdays between approximately 4pm-7pm and/or Saturdays between approximately 10am-2pm (You may select more than 1 answer)

  • Consents and Permissions

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