Sand Run Pharmacy - COVID-19 Vaccine Waitlist
Once you fill out this form, you will be added to the waitlist to be contacted about the COVID-19 vaccine when it becomes available at our pharmacy. We will reach out to you via phone call when the vaccine is available so that you can go to our website to register for your appointment.

We will be following the Ohio Department of Health priorities when it comes to scheduling the vaccine administration.

**VACCINE ADMINISTRATION IS BY APPOINTMENT ONLY**
First Name *
Last Name *
Age *
Phone Number *
Are you a part of phase 1b? (ex. age 65+ or a K-12 teacher) *
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