COVID-19 Vaccination REGISTRATION 

This page was last updated on 1/20/2021.

The Montgomery County Office of Public Health has started scheduling appointments for the Moderna COVID-19 vaccine for Phase 1A which includes qualifying healthcare staff who LIVE OR WORK IN MONTGOMERY COUNTY. 

If you have received ANY type of vaccine in the past 14 days, or plan to get a vaccine in the next 14 days, YOU CANNOT GET THE COVID VACCINE UNTIL 14 DAYS HAVE PASSED.

The Office of Public Health will review the responses and send a registration link to persons that fit into the 1A category, which will take them to an appointment system. Appointment confirmation and a medical license, badge, or paystub verifying employment will be required to receive a vaccination.

• Healthcare Offices and Healthcare professionals: Individuals employed by a healthcare office should have their office complete one survey form for all staff.
• Private Healthcare Contractors: Private contractors who work in the healthcare industries listed in the Phase 1A category below, and who do not have a primary employer may apply as an independent contractor. In this case, “Business Name” would be “Your Name Private Contractor.” Business contact information would be the individual’s contact information. A description of the individual’s work in the healthcare industry (as described above in 1A) should be included under “describe the service your agency providers.”

Pre-registration for individuals is for:

• Persons ages 65 and older
• Persons ages 16-64 with high-risk conditions:
  • Cancer
  • Chronic kidney disease
  • COPD
  • Down Syndrome
  • Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
  • Immunocompromised state (weakened immune system) from solid organ transplant or from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
  • Obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2)
  • Severe Obesity (BMI ≥ 40 kg/m2)
  • Pregnancy
  • Sickle cell disease
  • Smoking
  • Type 2 diabetes mellitus

Questions?

Any questions or concerns regarding vaccine registration MUST be directed to the Montgomery Country Office of Public Health at publichealth@montcopa.org. Veoci, our survey provider, will not be able to address any inquiries or provide any assistance on this matter.

Vaccine Clinic Information

Clinics will run Monday through Friday from 8:30 to 3:45 p.m. Due to the limited supply of vaccine available at this time, only eligible people will be scheduled appointments over the next few weeks. Appointments are required to receive the vaccine, no walk-up registration will be accepted. As more vaccine doses become available, more appointment slots and vaccination clinics will be opened.

PA Long-Term Care Facility State COVID-19 Vaccination Partnership

The PA Department of Health will be matching Long Term Care Facilities NOT enrolled in the federal partnership with potential vaccinators. Please fill out this form only if you are not already enrolled with the federal program and are interested in being matched with a state vaccination provider: