COVID Vaccine Scheduling Request
St. Clair is now able to offer the Pfizer/BioNTech Covid vaccine to all "Phase 1A health care personnel" as defined in Pennsylvania's Interim Vaccination Plan. If you meet the definition and are currently working in a zip code within St. Clair's service area, you can register to receive the vaccine through this online module. You will be asked to show proof of employment and location of employer at the Clinic.
Note that current supply of the vaccine remains limited. We will schedule in the order in which registrations are completed. Walk in services are not allowed.
Scheduling Request
Requestor Information
Patient Information
When Can We Contact You?
Requested Service
This request is for:
Please provide a first name.
Please provide a last name.
Please provide a relationship.
Please provide a first name.
Please provide a last name.
Please provide a birth date.
Please provide a phone number.
All return calls placed between 8:30 AM – 4:30 PM. Please select a return call time.
Please provide a return call time.
Please provide an Employer Name.
Please provide an Office Address.
Additional Comments / Notes:
By clicking Submit, you are attesting that you are a healthcare worker in phase 1A of the Pennsylvania Department of Health's Interim Vaccination Plan and work in a location within St. Clair's service area.

Your scheduling request has been submitted.

You will be contacted within 1 business day of submission by a scheduling representative to confirm your request for service.

Please have your insurance information and the doctors prescription/order for the requested service so we can confirm the visit.