If you are age 65 and over and are interested in getting a Moderna COVID-19 vaccine at Palms Medical Group, please complete the form below. The Moderna COVID-19 vaccine is administered as a 2-dose series, 1 month apart. If you are not comfortable using the form below, please call Palms Medical Group at 1-888-730-2374 to schedule a Moderna COVID-19 Vaccination Appointment.

If you have already completed this form, please do NOT resubmit or call, we will call you as quickly as we can. Thank you.

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If this is an emergency, DO NOT WAIT FOR CARE AND DO NOT USE THIS FORM. Please dial 911. To speak with an After Hours Nurse, dial 352-505-2854.
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To make an appointment at any location, or to speak with a Financial Services Specialist please call 1-888-730-2374

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Palms Medical Group is a FTCA Deemed Facility.
This institution is an equal opportunity provider and employer.
This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.
This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).
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