A ray of hope

We recognize that this has been an extremely challenging year for long term care staff and residents, as well as their loved ones.

It is very encouraging that the U.S. Food and Drug Administration (FDA) has found a COVID-19 vaccine to be safe and effective, We are pleased to be able to offer the vaccine to residents and our staff.

Before the pharmacy can give the vaccine, we need consent from resident and staff members, staff are to arrive at their appointment time with their completed COVID Vaccine Intake Consent Form.

Residents and staff will not have to pay out of pocket to receive the vaccine. You will be required to provide your insurance information.

The vaccine has been shown to provide a great deal of protection against serious illness due to COVID-19, and as such public health officials are encouraging residents and staff to to get this vaccine. The elderly population has a much higher risk for getting very sick, being hospitalized, or dying from COVID-19. The belief is that the more of us that get vaccinated, the better we can protect our families and our community against potential outbreaks.

This vaccine has gone through testing and clinical trials to ensure it meets the highest safety standards, please read the Emergency Use Authorization posted in the right column. The information indicates that those who have had the virus should get the vaccine. Potential side effects are listed on the fact sheet. You will find that these side effects are similar to the potential side effects of the flu shot, but they occur in more people. However, the health and safety of our residents and staff is always our top priority, and there is confidence this vaccine is a much better option than the risk of getting this virus.

The vaccine requires two doses, and those getting it will need to get both doses to ensure the best results. The second dose will be given approximately 21 to 28 days after the first dose.

Public health officials advise us to continue to take all necessary precautions after the vaccine is administered, including wearing personal protective equipment and conducting regular testing, to ensure the safety of our residents and staff.

We will continue to work with public health officials to determine how and when to adjust our policies for visitations and social activities and keep you updated.


COVID-19 Vaccine Clinic - by CVS at Maples

     Date: Saturday, February 13, 2021 - Tentative - stay tuned
     Time: 11:00 am - 5:00 pm by appointment
     Where: Main Dining Room

  • Employees are asked to arrive at the COVID Vaccine Clinic at your scheduled appointment time prepared with the completed CVS provided (paper triplicate form) COVID Vaccine Intake Consent form with your photo identification and a copy of front and back of your health insurance cards. The paper consent forms are now available at Maples. CVS will be onsite for 6 hours, during that time they will vaccinate all staff and residents, It is of utmost importance that everyone arrive prepared.(updated 12/23/2020)
  • for planning purposes we need to know now if you plan to receive the vaccine on clinic day or if you wish to decline the vaccine at this time.

    If you wish to RECEIVE the COVID Vaccine please complete the paper copy of the COVID Vaccine Intake consent form. Employees that are minors must have Parent or legal guardian complete a consent form. Please pick up a paper consent form (now available) for completion, and bring the completed form, a photo id and a copy of the front and back of your insurance card with you to the vaccine clinic.

  • If you wish to DECLINE the COVID Vaccine please complete the COVID-19 Vaccine Declination form (link below) - complete and return this form using the document upload feature. You may change your mind later. It is necessary that we have this information so that we can have an accurate count for the upcoming clinic.

  • COVID-19 Vaccine Declination form
  • If you have received the COVID Vaccine elsewhere please upload your COVID-19 Vaccination Record Card - please upload the card using the document upload feature after the 1st dose and again after you have received the second dose. We are required to report the COVID-19 Vaccination status numbers to the CDC.

    Resident / Families

    Each resident that would like to receive the COVID-19 Vaccine must complete the CVS Responsible Party Consent Form. This is true for those receiving either dose 1 or dose 2.

  • Attention Families: Please complete and return the COVID-19 Vaccine Responsible Party form authorizing the administration of dose 2 of the COVID Vaccine. We must have a Responsible Party Consent form for the second dose.
  • Please use the upload document link on the top of this page to securely upload completed documents to Maples. If you are unable to upload the document please drop the document off at Maples between 8 am and 8 pm. Blank Responsible Party Consent forms will be available in the vestibule if you are unable to print.

  • Residents will consent to vaccine administration unless there is an Activated Healthcare Proxy, in that case the Health Care Proxy must provide consent for resident.
  • COVID-19 Vaccine Responsible Party form - complete and return this form.
  • COVID-19 Vaccine Consent preview form - for reference only, do not return
  • COVID-19 Vaccination Information

  • Emergency Use Authorization and fact sheet for recipients and caregivers - Pfizer
  • Questions and answers about COVID Vaccine
  • COVID Vaccine Clinical Questions
  • Pfizer: Quick Access to Important Information
  • COVID-19 Vaccine Intake fillable consent form - for reference only, do not return (updated 12/23/2020)