COVID-19 Vaccine Interest Form for Individuals in Humboldt County, CA
Humboldt County residents who are interested in receiving a COVID-19 vaccine can fill out the Vaccine Interest Form for Individuals below. Vaccination appointments are made by invitation only. Public Health or a local healthcare provider will notify individuals when the vaccine is available for the phase and tier in which they are categorized, as outlined by the California Department of Public Health.
Please note: A valid email address is required to register and be notified of vaccine availability. If you don't have email, check
regularly to learn when vaccine becomes available. Announcements about vaccine availability also will be made through local media outlets. If you don't have access to email or the internet, please call the COVID-19 Community Information Line at 707-441-5000 for assistance.
Filling out the COVID-19 Vaccine Interest Form for Individuals does not book an appointment for vaccination.
If filling this form out for someone else, please provide your email in the field below. This information will be used to communicate vaccination clinic opportunities.
Are you completing this form on behalf of another person?
No, I am completing this form for myself.
Yes, I am completing this form for someone else.
If filling this form out for someone else, please provide your name and phone number, and use your email in the field above.
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