Answer screening questions

Risk factor screening questions

Please answer these questions the best you can to determine when you can get the vaccine.

Do you have any of the following health conditions? (Select all that apply)

Done registering

Thank you for registering your information.

There is no need to call to verify that this form was submitted successfully.

We’ll contact the email address or phone number provided as soon as you’re able to schedule a vaccine with a provider near you!

We prioritize vaccinations per Ohio and CDC guidelines. To learn more about our current criteria/phase, you can monitor our news feed or Facebook page.