This form should not be used to make an appointment to receive the COVID-19 vaccine.
Learn how to make a COVID-19 vaccine appointment →
Make an in-person or virtual appointment by filling out the form below or calling 888‑4GW‑DOCS.
A representative will contact you within one business day to set up your appointment. If this is an emergency, call 9-1-1 or go to your nearest ER.