1. Read the PhilaVax User Confidentiality Agreement: https://vax.phila.gov/index.php/documents/philavax-user-confidentiality-agreement/
2. Fill out the form below.
If you are updating your Confidentiality Agreement, no need to do anything - we will update your account and you can keep using PhilaVax.
If you are requesting a new account, a PhilaVax staff member will be in touch with you in about 2 or 3 days with login credentials.