Bucks County is currently pre-registering individuals for COVID-19 vaccinations who meet criteria in PHASE 1A, 1B, 1C of the State’s vaccination plan (see below for eligibility requirements). By completing this form you are pre-registering for a vaccination appointment as vaccine becomes available. Your submission will be evaluated and you will be contacted by e-mail or telephone when you are eligible for an appointment. Each individual pre-registering for a vaccination requires a separate form and must have their own e-mail address. If you do not have an e-mail address, please contact 1-800-383-0371 for assistance with pre-registration.

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Phase 1A

  • Long term care facilities
  • Emergency medical service personnel
  • Nurses & Nursing assistants
  • Physicians
  • Dentists & Dental hygienists
  • Chiropractors
  • Therapists
  • Phlebotomists
  • Pharmacists
  • Pharmacy Technicians
  • Health professions students and trainees
  • Direct support professionals
  • Clinical personnel in school settings or correctional facilities
  • Contractual HCP not directly employed by the health care facility.

    Persons ages 65 and older

    Persons ages 16-64 with high-risk conditions:

Phase 1A – Individual (Healthcare, 65+ or Qualifying Medical Condition)

(Healthcare business with a single provider use Individual link)

Phase 1A Healthcare Business Only

(Multi employee Businesses)

    Phase 1B

    • Law enforcement
    • Fire/rescue personnel
    • Emergency services personnel
    • Public transit staff
    • Grocery store staff
    • Educators/Education staff
    • Manufacturing staff
    • U.S. Postal Service staff
    • Clergy and other essential support for houses of worship
    • Corrections staff and other staff of non-1A congregate care settings
    • Individuals caring for children or adults in early childhood and adult day programs

    Phase 1B – Individual Sign up

    Phase 1B – Business Sign up

    Phase 1C‌

    • Finance staff, including bank tellers
    • Information technology
    • Energy
    • Food services
    • Housing construction
    • Communications
    • Legal services
    • Public health workers
    • Public safety
    • Utility
    • Water and wastewater staff
    • Federal/state/county/local government


    Phase 1C – Individual Sign up

    Phase 1C – Business Sign up