Alameda-Health-System

2021 Alameda County COVID-19 Vaccine Notification Form Is Here

Alameda County has a new form to fill out to be notified when the COVID-19 vaccine becomes available. It asks for your age, occupation, and whether you have any underlying conditions which may make you more susceptible to severe illness — all of which determine your eligibility for the vaccine, according to the State of California’s current guidelines.

What you’re about to click reads as follows:

Thank you for completing this form. Your response will help us continue to prioritize and plan for safe and equitable COVID-19 vaccine distribution in Alameda County. We will notify you when a vaccine is available and send you information with details on location and timing.

All responses will be kept confidential and will only be used for planning and outreach purposes. We will not share individual-level information with anyone. You will not be asked about immigration status.

Please see https://covid-19.acgov.org/vaccines#localplanning for more information about the COVID-19 vaccines and when they might be available for different groups according to the federal and state framework.

https://app.smartsheet.com/b/form/44974350ffd14f288b03b029f2486ba8

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