Vaccine Information

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We highly encourage that you please print and complete the appropriate vaccination screener and consent form, and bring the completed form to your appointment. This will help expedite the process when you arrive at the vaccination location. A form will be provided if you are not able to complete on prior to your visit.

If you need to make an appointment please click here.

Immunization Vaccine Screener & Consent Form (English) COVID-19 Vaccine Screener & Consent Form (Spanish)


Please review the appropriate Vaccine Information Statement (VIS) below:

  • Influenza Vaccine, inactivated or recombinant
  • Pfizer-BioNTech Vaccine Fact Sheet (12 yrs of age and older) - English | Spanish
  • Moderna Vaccine Fact Sheet - English | Spanish
  • Janssen J&J Vaccine Fact Sheet - English | Spanish
  • Pfizer-BioNTech Vaccine Fact Sheet (5 yrs to 11 yrs of age) - English | Spanish
  • Other Vaccines Information Statements - English

Please review other resources below:

  • CA digital vaccine card
  • After getting vaccinated we highly encourage you use your smartphone and participate in V-Safe to tell CDC about any side effects after getting the COVID-19 vaccine.


Rx Information

Other Outpatient Pharmacy Forms

  • Transferring Your Prescription is Easy
    Tell us the Prescription, Tell us which pharmacy, We do the rest.
    Transfer RX Form
  • COVID-19 at Home Test Kits
    Those covered by Medicare Part B, including those enrolled in a Medicare Advantage plan, or El Camino Health employees, and dependents covered under the hospital's medical plan, are eligible to receive up to eight over-the-counter COVID-19 tests each month at NO cost thru the Outpatient Pharmacy. This special program lasts until the end of the COVID-19 public health emergency is announced.
    COVID-19 at Home Test Kits