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COVID-19 Vaccine Appointments – Phase Two

COVID-19 VACCINATION FORMS

Fill out the form below and your registration will be reviewed.

Once appointments are available, you will be sent an email from the CDC asking for you to complete your registration on their website – VAMS – and make your appointment there. One registration per email address. Every registrant must use a different, unique email address.

On the day of your appointment, you will be required to present the following:

  1. Your government issued Photo ID
  2. Your insurance card

Please enter your unique email address. Only 1 person can be associated with each email address.
Please enter your first and last name here
Please enter your legal last name
Please enter your date of birth. mm/dd/yyyy