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COVID-19 Vaccine Registration Assistance
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瞭解詳情
Are you eligible for the current phase of COVID vaccine rollout in Texas? Eligible Categories: 1A for healthcare workers, 1B for age 65+ or underlying conditions, 1C for ages 50-64, and educators.
Yes
No
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Name
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Address
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Email address
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Phone number
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Date of Birth
MM
/
DD
/
YYYY
How far are you willing/able to travel?
up to 30 minutes away (one-way)
up to 60 minutes away (one-way)
up to 2 hours away (one-way)
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Please list any days/times that you are unable to attend a vaccine appointment.
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Is there anything else we should know? (vaccine preference, 1st or 2nd dose, etc)
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