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 NameLast Name

Email*

example@example.com

Phone Number*

Format: (000) 000-0000.

I am ENTER AGE years old

Healthcare WorkerFirst ResponderLTC resident

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

General PublicOther

ModernaPfizer