COVID Vaccine Registration
SpringVale Health Centers
204 S. Bellevue Ave., Dover, Ohio 44622
(formerly known as Community Mental Healthcare)
COVID-19 Vaccine Registration Sign Up
PLEASE READ BEFORE SUBMITTING REGISTRATION FORM
Information on Moderna COVID-19 Vaccine
Please read before submitting registering:
- SpringVale Health Centers (fka: Community Family Health Center) receives a limited supply of vaccines and we are distributing them according to the guidelines established by the Ohio Department of Health.
- If you have been scheduled to receive the COVID-19 vaccine with another agency or pharmacy, do not accept an appointment at SpringVale Health Center: Bellevue Ave.
- If you are unable to keep your vaccination appointment, please call us at 330.365.1781 right away.
- Our office staff will call you when it is your turn to receive the vaccine.
- Please only fill out and submit the form once.
- Please bring your vaccine card, if applicable.