COVID-19 Vaccination Information Request Form
Now Available Through Orange County

A Vaccination Information Request Form is now available for completion on the Orange County website for those individuals wishing to receive the COVID-19 vaccine as it becomes available.

As a reminder, the COVID-19 vaccine is currently being rolled out to specific groups in phases defined by the New York State Department of Health.

Additional information regarding eligibility can be found at:


If you are interested in completing the request form, please visit: