The City of Evanston is working to reach all Evanston residents who are homebound due to medical conditions or are otherwise unable to visit a vaccine provider.
 
If you fit this criteria, please complete the form below so the City can coordinate an in-home vaccination. (If you know someone who fits this criteria, please complete the form on their behalf.)
The Evanston Health & Human Services Department and Illinois Department of Public Health have fully adopted ACIP and CDC recommendations for bivalent boosters.

The bivalent COVID-19 boosters have been authorized for people ages 12 years+ (Pfizer-BioNTech) and for people ages 18 years+ (Moderna) who have completed the primary series.

Bivalent vaccines can be used as a single booster dose at least two months following a primary series or booster vaccination.

By completing this form you are not scheduling an appointment but will be added to a list to receive updates on the booster shot process.

This survey is HIPAA compliant, meaning your health information will be protected.

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* 1. First Name

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* 2. Last Name

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* 3. Date of Birth

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* 4. Email 

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* 5. If you are submitting this form on behalf of someone else, please provide your contact information.

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