Make an appointment
Have you been to an Allina Health clinic or hospital before?
If you're not sure, choose No.
Yes
No
What is your age group?
Select One
6 months to 11 years old
12 to 17 years old
18+ years old
Please select the facility or business unit you work in.
Choose One...
Hospital
Clinic
EMS
Corporate security
Home care services
This field is required.
Vaccine Locations
View information about our vaccine locations.
Please call 612-262-5533 to schedule.
COVID-19 Vaccine Minor Consent Form
(Print, have parent/guardian sign, and bring to appointment)
Vaccine Locations
View information about our vaccine locations.
Annandale Clinic
Apple Valley Clinic
Bandana Square Clinic
Blaine Clinic
Bloomington Clinic
Brooklyn Park Clinic
Buffalo Clinic
Buffalo Crossroads Clinic
Centennial Lakes Clinic
Champlin Clinic
Chaska Clinic
Cokato Clinic
Coon Rapids Clinic
Eagan Clinic
East Lake Street Clinic
Edina Family Clinic
Faribault Clinic
Farmington Clinic
Forest Lake Clinic
Greenway Clinic
Hastings Clinic
Highland Park Clinic
Inver Grove Heights Clinic
Lakeville Clinic
Maple Grove Clinic
Maplewood Clinic
New Ulm Clinic
Nicollet Mall Clinic
Northfield Clinic
Oakdale Clinic
Plymouth Clinic
Ramsey Clinic
Richfield Clinic
River Falls Clinic
Savage Clinic
Shakopee Clinic
Sharpe, Dillon, Cockson & associates Clinic
Shoreview Clinic
St. Michael Clinic
Vadnais Heights Clinic
West St. Paul Clinic
Woodbury Clinic
Vaccine Locations
View information about our vaccine locations.
Annandale Clinic
Apple Valley Clinic
Bandana Square Clinic
Bloomington Clinic
Buffalo Clinic
Champlin Clinic
Cokato Clinic
Coon Rapids Clinic
Eagan Clinic
Edina Family Clinic
East Lake Street Clinic
Faribault Clinic
Greenway Clinic
Hastings Clinic
New Ulm Clinic
Northfield Clinic
Oakdale Clinic
Plymouth Clinic
Richfield Clinic
Savage Clinic
Sharpe, Dillon, Cockson & associates Clinic
Vadnais Heights Clinic
West St. Paul Clinic
COVID-19 Vaccine Minor Consent Form
(Print, have parent/guardian sign, and bring to appointment)