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Vaccination Registration - Gouverneur Hospital, February 26

The St. Lawrence County Public Health Department will be administering COVID-19 vaccinations in conjunction with St. Lawrence Health Systems this Friday, February 26th from 8am-4pm at Gouverneur Hospital for priority group 1b—essential workers who meet criteria. You must verify that you meet eligibility criteria by:
1.    showing your driver’s license or equivalent
2.    completing the NYS Vaccine Form
3.    providing other documentation or identification as stated below 

The 1b group currently includes:

-Public Safety (law, fire, EMS, probation) – ID
-Grocery Workers – letter from employer or pay stub required
-Restaurant Workers and Drivers-- letter from employer or pay stub required
-Court staff (judges not at this time) – ID, name badge
-Transit workers -- ID, name badge
-P-12 Schools (faculty or staff including contractors and student teachers) -- ID, name badge
-In person college faculty and instructors -- ID, name badge
-Childcare workers – ID or letter of self employment

There are two steps to complete the registration process for a vaccine:
1.    Registration:
2.    Completion of the eligibility form prior to your vaccination: NYS Vaccine Form  

Please bring proof that both the registration and the eligibility have been completed either by printing or taking a screenshot on your phone. 

Please also review these guidelines to ensure you are eligible on Friday:

  • If you are currently in isolation or quarantine due to COVID-19, you are not eligible. You will need to schedule at a later date upon availability.
  • You must be at least 18 to receive the Moderna vaccine.
  • You must be available for the second dose on March 26th. 
  • If there are no slots left when you go to register, please let the Public Health Department know by sending an email with your name, phone number, and the location you are trying to sign up for to [email protected] and you will be placed on standby.
  • Please enter the hospital no earlier than 5 minutes before your appointment time to maintain COVID-19 safety and prevent gathering. 

Below is a screen shot of what your registration ticket will look like and confirmation of vaccine form submission. Please bring copies or screen shots of them with you.


Registration Ticket ImageVaccine Form Image









Registration Ticket Image
Vaccine Form Image


Thank you for your support of the COVID-19 pandemic.