FCCHD Vaccine Clinic Appointment Scheduling Form


NOTICE

  • By completing and submitting this form, you are scheduling an appointment to receive a COVID-19 vaccine.
  • Type and quantity available are subject to change each week.
  • Please fill this form out for each individual who is need of an appointment.

This scheduling site will be updated regularly to reflect new appointment slots as staffing needs are determined and met. If there are no available appointments at this time, please continue to check back on this website to schedule an appointment when one becomes available.

Personal Information


Please do not include additional health information. This will be gathered when we call to schedule appointments.

Vaccination Prescreening

Prescreening - Have you been vaccinated for Covid-19?