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Enroll to be COVID-19 vaccination provider
Submit information for higher risk patients who are eligible for vaccination. See more information here.
Vaccine providers are trusted sources who can offer information about the COVID-19 vaccines for their patients and community. With the expeditated process to get these vaccines in arms, many have questions about the shots’ efficacy, safety, and side effects. Providers can help dispel myths and encourage their patients to get vaccinated.
For questions about clinic documentation, scheduling, administration or others, please reach out to your district coordinator or submit them here on IDOH's provider portal.
Patient education:
- Vaccine fact sheet in multiple languages
- CDC Answering patient's questions
- Myths and Facts (CDC)
Provider Toolkit:
- COVID Vaccine Posters
- Johnson & Johnson Palm Card (English) (Spanish) (updated 6/07/21)
- Moderna Palm Card (English) (Spanish) (updated 6/07/21)
- Pfizer Palm Card (English) (Spanish) (updated 6/07/21)
- Vaccine Hesitancy Information: Includes sample communication, tips and other resources
- COVID-19 Vaccine Guidance Tool for Patient Inquiries
- Benefits of vaccination (English) (Spanish) (updated 6/5/21)
- Fact Sheet for 12-15 year olds (English) (Spanish) (updated 6/5/21)
- Fact Sheet for older teens (English) (Spanish)
Resources:
- Provider Fact Sheet (English | Spanish)
- Visit General information on COVID-19 Vaccine in Indiana for information on:
- Vaccine storage and handling
- Training and administration guides
- Pfizer and Moderna vaccine fact sheet and printable pocket guides
- Zotec quick reference guides
- Children and Hoosier Immunization Registry Program (CHIRP)
- Indiana COVID-19 Vaccination Dashboard
- Indiana Vaccine Latest News and Resources
Enrollment:
- COVID-19 Vaccination Patient Intake Form
- For a Patient - How to Schedule an Appointment for a Vaccine
- Patient Consent Form
- For Facility Staff - Registering Users in Zotec
Dosing and side effects:
- Schedule, doses and other facts for Pfizer-BioNTech vaccine
- Schedule, doses and other facts for Moderna vaccine
- Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States
- Interim Considerations: Preparing for the Potential Management of Anaphylaxis After COVID-19 Vaccination
- Vaccine Adverse Event Reporting System
- V-safe after vaccination health checker
Additional resources:
- CDC clinical resources for Each COVID-19 Vaccine
- CDC COVID-19 Vaccine FAQs for Healthcare Professionals
- John Hopkins COVID-19 center
- HHS
- FDA
- ACIP
- AMA
- Reproductive Care Recommendations from American Society for Reproductive Medicine
- Society of Breast Imaging recommendations: SBI Recommendations for the Management of Axillary Adenopathy in Patients with Recent COVID-19 Vaccination
This site was last updated 6/18/2021 3:50 PM
