COVID-19 Vaccine Registration Forms

Please read before submitting form below: 

The Onslow County Health Department is now accepting COVID-19 Registration Forms for 65+  *Please see link below. 

Fill out the form completely and SAVE. No need sign (you can sign when you get to the Vaccine Clinic.) Once the form is filled out and saved, email it to OCHD-Vaccine@onslowcountync.gov. *Please note that depending on the type of internet browser you are using (Google Chrome, Firefox, Internet Explorer, etc.) the ability to download and save may look different. Always check the file before sending to make sure all the information you filled was saved. Someone will call to schedule your appointment. 

The Health Department asks that you remain flexible with your time because schedulers will try to fit you in at the earliest available appointment.

What to bring to Vaccine Clinic for Scheduled Appointment

Bring photo ID

Bring any applicable medical insurance card(s)

Note: if you participate in a Medicare Advantage Plan, the COVID-19 administration claim must be submitted to your Original/ Traditional Medicare (red/white/blue card). Share your Original/ Traditional Medicare information on this form and/ or bring your card to your appointment. medicare

 

For further questions or concerns please call the Citizens Phone Bank 910-989-5027.

 

If you are returning for a second dose. There is no need to call to schedule with the Citizens Phone Bank. You will be receiving a call from a Health Department team member with available appointment times. 

COVID-19 Registration Forms for Phase 65+ (Please fill out form no need to sign you will sign at scheduled appointment)