Vaccination Sign Up Form
‌(Phase 1C)

·         All adults aged 65-74

·         Persons aged 16-64 with underlying health conditions

·         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

Note that at this time only the Pfizer-BioNTech product is approved for those age 16 and 17.

*These categories are general groups. For a more granular list of eligible positions please consult the DOH vaccine plan found here:
https://www.health.pa.gov/topics/Documents/Programs/Immunizations/
‌PA%20Interim%20Vaccine%20Plan%20V.4.pdf


*Additional vaccine guidance can be found at the Department of Health's website here:
https://www.health.pa.gov/topics/disease/coronavirus/Pages/Vaccine.aspx

Vaccination Sign Up Form For Business