This form is for individuals who wish to receive a Pfizer dose COVID-19 vaccine at the:
Masjid AbuBakr AlSaddiq Muslim Community Center
2001 West 10th st. Antioch, CA 94509
Only individuals 12 years or older will be vaccinated.
Those under the age of 18 must be accompanied by a guardian.
Bring your CDC vaccination card for second dose shots.