• COVID-19 Vaccination E-registration

    Hilo Civic Auditorium | Friday, January 15, 2021 | Deadline to Register: 1/12/2021

  • Aloha!  This quick form will allow us to quickly register each patient into the Vaccine Administration Management System (VAMS) with your specific demographic data. 

    Please enter the following information for each vaccine recipient.

    Fields with * are required.

    Thank you!

  • Salutation*
  • Gender*
  • Date of Birth*
     - -
  • Ethnicity*
  • Race*

  • The clinics will be held on Friday, 1/15/2021 from 8:30am to 2:30pm. Please select one appointment time.
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