Register for COVID Vaccination Information
The state has created a vaccination phasing plan that the city is required to follow. You can see the full plan at www.mass.gov/covidvaccine.

Please answer all the questions below, and we will contact you once a vaccine is available within the phase you qualify for. No vaccines are permitted to be given out prior to the phase in which you are eligible.
Email address *
Contact Information
First and Last Name *
Phone Number *
Can we text you at the phone number provided *
Full Address *
Qualifying questions
1. Do you have any of the following qualifications for Phase 1? *
2. If the answer to Question 1 above was yes, please provide more details
3. Your age *
4. Do you have a "co-morbid condition"? *
Visit the following site for a list of such conditions: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. You will be required to provide proof of condition.
5. Are you employed in any of the following fields? *
Do you have any other reason besides those listed above that you believe you would qualify under the state regulations for Phase 2 of vaccinations?
Are you able to leave your house to receive a vaccine? *
A copy of your responses will be emailed to the address you provided.
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