Pre-Register for COVID-19 Vaccine

Baltimore County residents who want to be vaccinated should complete the below form.

Completing this form does NOT schedule a COVID-19 vaccination appointment. This form is intended to create a registry for those interested in receiving the vaccination as vaccine becomes available.

After completing the form, you will be contacted by Baltimore County staff once you become eligible AND when vaccines are available, with additional information about how to schedule your appointment.

If you are unable to complete the survey online, please ask a friend, neighbor, or family member for assistance.

If you are a health care provider and you have already completed the provider registry, you do not need to complete this form.

The information that you give us will only be used to schedule a vaccine appointment. It will not be shared outside of Baltimore County Department of Health.

Please note: There is limited supply of vaccine nationwide. Please be patient as we work to provide everyone in our priority groups with an opportunity to make a vaccine appointment.

Click Here for Pre-Registration Form

• More Information about Pre-Register for COVID-19 Vaccine