COVID Vaccination Registration - Hot Springs County Wyoming

Register - COVID-19 Vaccination List

Hot Springs County, Wyoming residents who meet one or more of the following criteria may now register for the COVID-19 vaccine waiting list.

Please complete this form if any of the following applies to you.

You must be a resident of Hot Springs County, Wyoming AND 18 years of age or older to proceed.

Once registered you will be contacted by Hot Springs County Public Health or Red Rock Family Practice to book your appointment. It may be weeks before you receive this call. If possible, please print and complete the Vaccine Consent Form to the right and bring to your appointment. Forms are also available in the alcove at Hot Springs County Public Health, 117 N. 4^th Street. Please wear short sleeves to your appointment. For questions, please call Hot Springs County Public Health at 307-864-3311.

Name

Date of Birth

Phone

Address

Human Test

	COVID Vaccine Consent Form 549 Downloads	328.47 KB
	What to expect from your COVID vaccine 229 Downloads	199 KB
	Vaccine fact sheet-MODERNA 205 Downloads	143.95 KB
	Notice of Privacy Statement 87 Downloads	199.5 KB
	Consent Form Instructions 161 Downloads	40.59 KB
	Johnson and Johnson COVID-19 Vaccine Fact Sheet 84 Downloads	120.97 KB

	Order 1 25th Continuation 4 Downloads	321.57 KB
	Order 2 25th Continuation 3 Downloads	320.27 KB