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COVID-19 Vaccine Consent form:

Posted Date: 09/02/2021

COVID-19 Vaccine Consent form:


SRCS has been working with Guadalupe County Hospital to offer a COVID-19 vaccination clinic to students who are 12 years of age or older (some 6th graders), 7th-12th graders.  Consents have been given to students to take home for parents/guardians to sign.

We need consents to administer vaccines at school.

We will try to schedule the vaccine clinic during the month of August, so students can take advantage to the $100 incentive offered by the NM Dept. of Health at  or call 1-855-600-3453.

Once students have received one vaccine they are eligible to apply for the $100.

Any questions please contact Tommie Salinas, school nurse at 575-799-3198.

Below are the Consent forms:

English Consent form COVID vax.pdf

Spanish Consent form COVID vax.pdf