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Alliance Health Vaccinations

Please complete the form below to notify Alliance City Health Department of your interest in receiving a COVID-19 vaccine. Entering your name on this form does not schedule your appointment or guarantee that vaccine can be made available to you.

Your request will be prioritized according to your age group and you will be contacted to schedule an appointment as soon as vaccine is available. Please do not contact the department to request your status.
Unless you have updated information, please do not complete this form more than once per individual.