Lebanon County CVC Vaccination Standby List
This sign up form is for individuals that would be interested in getting any surplus doses available at the end of a scheduled vaccination day. A quick response is required (20 minutes or less) to the community vaccination center (1745 Quentin Rd #7699, Lebanon, PA 17042 - old Kmart building).

This is not a guarantee that you will receive a vaccine. This is only a list that will be used to fill a few remaining doses at the end of any given vaccination day. Doses are first come first serve and will be prioritized to those that are currently eligible.

Walk ups will not be accepted. Only people on this list will be considered for surplus doses.

By signing up here you are agreeing to accept any of the vaccines currently approved for emergency use.  If you are looking for a specific vaccine, DO NOT USE THIS FORM as we cannot guarantee availability of a specific vaccine.
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Email *
I am within 20 minutes of the site *
Phase Eligibility *
Last Name *
First Name *
Telephone Number *
Terms and Conditions:
* Must answer the phone when we call. No messages will be left and you will be removed from the list.
* Must be able to get to the CVC in no more than 20 minutes.
* If you already have an appointment at the CVC, you are not eligible to be on the standby list.
* Must agree to coming back to this CVC for your second dose.
* By signing up here you are agreeing to accept any of the vaccines currently approved for emergency use. If you are looking for a specific vaccine, DO NOT USE THIS FORM as we cannot guarantee availability of a specific vaccine.
I agree to the above terms *
A copy of your responses will be emailed to the address you provided.
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