Coronavirus

Doctors can now decide who needs a COVID vaccine. Here’s the form you need

How do you know if your medical condition makes you eligible for a COVID-19 vaccine?

Your doctor will decide, Florida Gov. Ron DeSantis said Wednesday.

And starting Wednesday, people under 65 with a high-risk medical condition will need a physician to sign an eligibility form before they can get vaccinated at a Florida doctor’s office or pharmacy.

Florida’s Department of Health released a link to the one-page form late Tuesday night. The form can be downloaded at floridahealthcovid19.gov.

Basic information about the physician is required — name, phone, email, medical license number and the address of the physician’s practice. The form also asks for the patient’s name, date of birth, address and telephone number.

The form does not ask the physician to list a patient’s medical condition. It also doesn’t provide a list of eligible high-risk conditions.

Instead, physicians have to sign the form if they can certify they have a “physician-patient relationship” with the person listed on the document and have determined the patient to be “extremely vulnerable to COVID-19” and in need of the vaccine.

So, which medical conditions qualify?

It’s the doctor’s call. And a physician doesn’t have to disclose specific conditions on the form.

“We think trusting our doctors is the way to go. I think most of the physicians — they have to sign their names to this — they obviously want this to be something legitimate so I don’t think we’re gonna see any funny business with it,” DeSantis said at a Wednesday news conference in Zephyrhills.

“They’ve seen how this virus has impacted different folks. They can take a look and they can make that determination based on underlying conditions,” he said.

Previously, only hospitals were allowed to vaccinate people under 65 with pre-existing health conditions that made them at risk for severe COVID complications. Late last week, DeSantis signed an executive order allowing doctor offices and pharmacies like Publix and CVS y mas to also vaccinate individuals determined by a physician to be “extremely vulnerable to COVID-19.”

Which South Florida hospitals are offering COVID-19 vaccines to people with at-risk conditions?

In South Florida, Broward Health and Holy Cross Health recently began offering vaccination appointments to people who have certain health conditions that make them at risk for severe COVID infection. Both hospitals used a list of at-risk conditions by the Centers for Disease Control and Prevention to create their criteria.

Jackson Health System, Miami-Dade County’s public hospital network, also used the CDC list late last month to make a list of 13 conditions. On Tuesday, the hospital announced it was scrapping that list and is now vaccinating people 50 and older who have any high-risk medical condition.

As of Wednesday, Broward Health said it will not be accepting the state-issued form for at-risk patients because it already has its own form people need to fill out during registration.

Jackson Health said it will accept the state’s at-risk form for people who are 50 and older. It will also continue to accept a doctor’s note for this age group.

The note must be on the physician’s letterhead or on a prescription pad and list the patient’s name, a recommendation for the vaccine and which medical condition the person is being treated for.

Other hospitals and pharmacies have not announced whether they will change their policies and use the state’s one-page doctor’s form.

Florida At Risk Conditions Form by Michelle Marchante on Scribd

This story was originally published March 3, 2021 at 11:06 AM.

Follow More of Our Reporting on Coronavirus & Vaccines: What You Need To Know

Michelle Marchante
Miami Herald
Michelle Marchante covers the pulse of healthcare in South Florida and also the City of Coral Gables. Before that, she covered the COVID-19 pandemic, hurricanes, crime, education, entertainment and other topics in South Florida for the Herald as a breaking news reporter. She recently won first place in the health reporting category in the 2025 Sunshine State Awards for her coverage of Steward Health’s bankruptcy. An investigative series about the abrupt closure of a Miami heart transplant program led Michelle and her colleagues to be recognized as finalists in two 2024 Florida Sunshine State Award categories. She also won second place in the 73rd annual Green Eyeshade Awards for her consumer-focused healthcare stories and was part of the team of reporters who won a 2022 Pulitzer Prize for the Miami Herald’s breaking news coverage of the Surfside building collapse. Michelle graduated with honors from Florida International University and was a 2025 National Press Foundation Covering Workplace Mental Health fellow and a 2020-2021 Poynter-Koch Media & Journalism fellow.  Support my work with a digital subscription
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