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Are you extremely vulnerable to COVID-19 and want the vaccine? Have your doctor sign this form

FLORIDA — If you are extremely vulnerable to COVID-19 and would like to get vaccinated, your doctor will need to sign this form.

Florida Gov. Ron DeSantis issued Executive Order 21-47, which states physicians, advanced practice registered nurses, and pharmacists can vaccinate people “determined by a physician to be extremely vulnerable to COVID-19.”

The executive order goes into effect Wednesday, March 3.

The Florida Department of Health has published a form titled “COVID-19 Determination of Extreme Vulnerability” for physicians to certify that a person is deemed extremely vulnerable to COVID-19 and eligible to receive the vaccine.

The form can be found by clicking here.

Aurielle Eady

Aurielle Eady, Action News Jax

Aurielle Eady is a digital content producer for Action News Jax.