Phase 1C - COVID Vaccine Request

The following people are considered eligible for vaccination in Phase 1C 
 
  • Adults aged 40 to 64 with high-risk medical conditions

  • Other essential workers


 
If you are in the Phase 1C Category AND need to receive the vaccine from your local health department please complete the survey below. Only certain health departments currently have vaccine.  You will be asked which health department you prefer to be contacted by for your vaccine appointment. After you register here, YOU WILL BE CONTACTED BY EMAIL, TEXT OR PHONE for your appointment as the vaccine becomes available. Note*  Any email or text received for an appointment for a vaccine is meant solely for the person to whom it was sent.


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* 1. Please enter your contact information:

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* 2. Is your phone number...?

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* 3. Date of Birth

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* 4. Phase 1C  Group

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* 5. Only certain health departments currently have vaccine.  Please select which health department you prefer to be contacted by for your vaccine appointment:

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