As part of the Virginia Department of Health, the Arlington County Public Health Division (ACPHD) is currently offering COVID-19 vaccines to those priority groups identified in Phase 1a and Phase 1b.
Those who are eligible for vaccination as part of Phase 1c can also fill out the form. They will be notified to make a vaccination appointment when Arlington moves into Phase 1c.
After completing the form below, you will be contacted when vaccine and scheduling is available for your priority group.
COVID-19 Vaccination Pre-Registration Forms:
- Arlington Healthcare Personnel in Priority Group 1a
- Individuals in Arlington County who are not Frontline Essential Workers in Priority Groups 1b and 1c
- Employers of Frontline Essential Workers in Priority Groups 1a, 1b and 1c *
- *Individual Essential Workers should work with their employers to pre-register the organization
- Phase 1a: Healthcare Personnel and Residents and Staff of Long Term Care Facilities
- Phase 1b: Persons aged 65 and older; People aged 16 through 64 years with a high risk medical condition or disability that increases their risk of severe illness from COVID-19; Essential Frontline Workers: Police, Fire, and Hazmat; Corrections and homeless shelter workers; Childcare/K-12 Teachers/Staff; Food and Agriculture (including Veterinarians); Manufacturing; Grocery store workers; Public transit workers; Mail carriers (USPS and private); Officials needed to maintain continuity of government.
- Phase 1c: Other essential workers as defined by VDH, including waste removal workers food service, institutions of higher education faculty/staff and public safety (engineers).
The information provided will be used to pre-register you in the CDC’s Vaccine Administration Management System (VAMS). Once this is complete, ACPHD will email you to schedule an appointment as vaccine and appointments are available.
Pre-registration does not mean your will be offered the vaccine immediately. You or your organization will only be contacted if there are any questions or follow-up needed before submitting your information.
Thank you for your patience during the phased distribution of the COVID-19 vaccine.