1: Am I eligible for a COVID-19 vaccine at this time?
Before registering for an appointment please use the Pennsylvania Department of Health tool to determine if it is your turn to receive the vaccine. You can find this tool here: https://covidportal.health.pa.gov/s/Your-Turn
Please Note: If you have limited access to online services or technology, or you need assistance in registering, you can email firstname.lastname@example.org
2: Once you submit the form will I receive additional communication via email ?
Once you submit your form, you will receive a confirmation email to the address you provided (be sure to verify E-mail),
3. Is there a Guidelines from PA State ?
· PA Department of Health Guidelines on the phases of Vaccine Distribution.
4. Can I download sample Form to print?
· Click for: Sample Vaccination Form: