I affirm:

• That I live, work, or study in Minnesota.

• That I am 18 years of age or older or that that I am the parent or legal guardian of the patient and that the patient is 12 years or older

You will be asked for your insurance information, whether you have insurance or not, you will not be charged for the vaccine. The federal government is providing the vaccine 100% free of charge to all people living in the United States, regardless of their immigration or health insurance status. We are required to ask for a driver’s license or legal ID but you are not required to provide it.