COVID-19 Vaccine Registration Form

ATTENTION: Please complete this form only if you are registering for your FIRST COVID-19 vaccine dose. You do not need to complete this form if you are waiting for your second dose.

You must bring your Driver’s License or State Identification Card and proof of employment (e.g. employee ID/badge, recent pay statement, or employer’s letter) if you have identified as a healthcare worker.


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Vaccine Info

Prior to completing your appointment registration, please download and read the following EUA Fact Sheets for the Pfizer and Moderna COVID-19 vaccines.

If you have questions regarding COVID-19 vaccination, please refer to Frequently Asked Questions about COVID-19 Vaccination as outlined by the Centers for Disease Control and Prevention (CDC). For more information on what to expect after getting a vaccine, please refer to the CDC’s guide.