To schedule an At Home appointment in this region:

• Select an open appointment time from the calendar below
• Check type of vaccination the patient is requesting and click register
• Complete the online registration form and submit
• Appointment details will be sent to the provided email after registering

Important Notes:

• Up to 10 people can be vaccinated during a single scheduled At Home appointment. Please schedule only one appointment per household.
• If multiple people are expected at one appointment, choose ONE of the patients to be registered using this form. All other patients will be registered separately at the time of the appointment.
• No government issued ID or insurance is required. Anyone under 18 must have a parent or guardian with them to sign consent.

Must have started vaccination series on or after September 4 to be eligible for second-dose incentive

Vaccine EUA

Patient acknowledges that they are receiving a vaccination that is currently covered under Emergency Use Authorization, and has reviewed the Pfizer-BioNTech EUA or Janssen EUA provided by the FDA for the vaccine that they are receiving.