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March 18, 2024
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COVID-19 Vaccine Information and Forms
Updated On: Jan 03, 2021

FROM FIRE ADMINISTRATION 12.31.2020

All Fire Suppression and EMS response Staff:

Attached is important information regarding the upcoming COVID Vaccine opportunity. Please carefully review the Information Bulletin 20-07, the COVID Vaccine Declination Form—if you choose not to receive the vaccine at this time, and the *COVID pre-screening and agreement form—fillable PDF. If you choose to do the pre-screen form via the fillable PDF, please note that you will need to print it and bring it with you, in order to receive the vaccine at your scheduled time. This is the same form that you will receive at the fire station—prior to your scheduled date—in hard copy form and can easily fill it out and bring it with you

If you choose to use the declination form, the completed fillable form can be securely sent to Fire-HRWorkComp@ci.stpaul.mn.us and Fire HR will file it. If you would rather deliver a hard copy to HQ, please send it to the attention of Tracey Blees or Nancy Denkinger.   

Finally, you will also find an information sheet on the Moderna COVID -19 Vaccine Emergency Use Authorization (EAU) Recipients, “What to Expect Card” which should assist in answering questions.  

**BLS and Station 51 staff, please go on one of the dates noted in the schedule—off duty—with the station that your Ambulances are assigned.


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