Attention!
Read the following instructions carefully.
Failure to do so may PREVENT you from being vaccinated.
Instructions:
1) Identify your eligibility category. View eligible groups: Click here
*Note* You will be asked to verify your eligibility at your appointment. If you cannot - you will be REFUSED vaccination.
2) Select your eligibility category from the options below.
*Note* If your eligibility category is NOT listed below DO NOT complete the form. Please check back frequently - we will add categories as the State releases them.
3) Complete the rest of the form and submit your response.