If you have pre-registered for a COVID-19 vaccine on ANY wait list in Delta County since December 2020 and you wish to REMOVE your name from our pre-registration list because you got the vaccine somewhere else, no longer want it, etc. please complete this form.

 Any submissions via this form will be REMOVED  from the pre-registration and you will NOT be contacted for an appointment to receive the vaccine.

DO NOT USE THIS FORM TO REGISTER.

Thank you.

Delta County Health Department/Delta County Emergency Management/Delta County Memorial Hospital