COVID Phase email

**THIS IS NOT A WAIT LIST**

If you would like to recieve an email or telephone notification of appointment availablity

Please complete the following

Name *

First Name Last Name

Email *

example@example.com

Phone Number *

I am ENTER AGE years old

Phase 1 (all eligible)

Healthcare Worker First Responder LTC resident

Phase 2

Individuals age 75+ Individuals age 65+, individuals 18-64 with 2+ comorbidities &/or residents and staff of low income and affordable senior housing K-12 educators, child care workers and school staff Other workers (public works, grocery, retail, food service, transportation) Individuals age 55+ Individuals with one co-morbid condition

Phase 3

General Public Other

Vaccine *

Moderna Pfizer