Vaccination Sign Up Form
‌(Phase 1B)

Must be a Bucks County resident or employed in the county and one of the following:

• First responders
• Correctional officers and other workers serving people in congregate care settings not included in Phase 1A
• Food and agricultural workers
• U.S. Postal Service workers
• Manufacturing workers
• Grocery store workers
• Education workers
• Clergy and other essential support for houses of worship
• Public transit workers
• Individuals caring for children or adults in early childhood and adult day programs

**These categories are general groups. For a more granular list of eligible positions please consult the DOH vaccine plan found here:

**Additional vaccine guidance can be found at the Department of Health's website here:

Vaccination Sign Up Form For Business