Town of Orange Online Covid-19 Vaccine Enrollment

(for Eligible Individuals)


The Orange Health Department has developed a COVID-19 Vaccine survey to allocate the COVID-19 vaccine supply according to the Phases established by the CT DPH   


The Orange Health Department will be updating the eligibility criteria based on the CT DPH guidelines
 

 

Currently, we are hosting our COVID-19 clinics at the High Plains Community Center located at 525 Orange Center Rd, Orange, CT 06477

 

Please  Fill out this simple vaccination survey form.  You will need to enter your full name, date of birth, eligible occupation (including “retired”), and email address. The information you enter will only be used for purposes of scheduling your vaccination, and will be kept private.

Once registered, you will be contacted directly by the Health Department to schedule your appointment at our COVID-19 vaccine clinic.

Please note that EACH individual who completes the survey MUST have their own unique email. No duplicate emails should be used.

COVID19 Vaccination Survey – COMPLETE THE SURVEY ONLY ONE TIME with One Email per person. This is not a registration.



Click here for the form




The Orange Health Department has developed a COVID-19 Vaccine survey to allocate the COVID-19 vaccine supply according to the Phases established by the CT DPH   


The Orange Health Department will be updating the eligibility criteria based on the CT DPH guidelines.  The location and times of the clinic sites will be posted once the COVID-19 vaccines have been received.


The Orange Health Department has developed a COVID-19 Vaccine survey to allocate the COVID-19 vaccine supply according to the Phases established by the CT DPH   


The Orange Health Department will be updating the eligibility criteria based on the CT DPH guidelines.  The location and times of the clinic sites will be posted once the COVID-19 vaccines have been received.