Form Center

COVID-19 Vaccine Questions & Comments

2. Please Read This First
   Maricopa County is currently vaccinating the following eligible groups: healthcare workers/EMS, residents of long-term care, law enforcement, Pre-K12 school staff, childcare workers, frontline essential workers and ages 18+. Please consult the FAQs for common questions. https://www.maricopa.gov/COVID19VaccineFacts <br><br> New appointments are becoming available every week for those eligible. Appointment locations, availability and information will be updated regularly here:  https://www.maricopa.gov/COVID19VaccineLocations<br><br> Due to the volume of submissions we are not able to respond to all individual requests. Thank you for your inquiry and know that we are doing our best to answer questions and inquiries in the order received.

   Maricopa County is currently vaccinating the following eligible groups: healthcare workers/EMS, residents of long-term care, law enforcement, Pre-K12 school staff, childcare workers, frontline essential workers and ages 18+. Please consult the FAQs for common questions. https://www.maricopa.gov/COVID19VaccineFacts
   
   New appointments are becoming available every week for those eligible. Appointment locations, availability and information will be updated regularly here:  https://www.maricopa.gov/COVID19VaccineLocations
   
   Due to the volume of submissions we are not able to respond to all individual requests. Thank you for your inquiry and know that we are doing our best to answer questions and inquiries in the order received.

4. Name*

6. Email*

7. Phone

9. Preferred Contact Method*

   (check one)

   1. Email
   2. Phone
10. Zip Code*

12. I need information about:*

    1. Phase 1A
    2. Phase 1B

    1. Future phases
    2. Other

14. Your question/concern is about:*
    -- Select One --An appointment I already scheduledEligibility/if my job qualifies meProblems using registration systemScheduling my second doseOther

    Select the most relevant.

16. Your comment or question*

Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field