Corpus Christi-Nueces County Public Health District

Vaccination Registration

If you have severe reactions with immunizations, please consult with your physician prior to registering for COVID-19 vaccination.

COVID-19 Vaccine is currently being distributed in a phased approach based on the recommendation of the Department of State Health Services and the Expert Vaccine Allocation Panel. This registration form will ask qualification questions and only allow registration if you meet the criteria.

It is recommended to use your mobile phone to register for the vaccination, so you can screenshot the QR code at the end of the registration. Upon arrival, you will show the screenshot photo from your phone screen for speedy check-in.

OR, if you use your home computer for this registration, please have a printer available so you can print the QR code at the end of the registration.

OR, if you are not able to use your mobile phone and do not have a printer, please write your name, date of birth and phone number and place in your windshield.

PRIOR TO PROCEEDING, you must read the Emergency Use Authorization Fact Sheet for the Moderna COVID-19 vaccine. You must be 18 or older to receive the Moderna vaccine.

PRIOR TO PROCEEDING, you must read the Emergency Use Authorization Fact Sheet for the Pfizer COVID-19 vaccine. You must be 18 or older to receive the Pfizer vaccine.

By proceeding and giving consent, you acknowledge your understanding of the risk and benefits. IF YOU DO NOT CONSENT, YOU MUST NOT PROCEED PAST THIS PAGE

By answering 'Yes' to the 'I GIVE CONSENT' question on the following page, you GIVE CONSENT to the Corpus Christi-Nueces County Public Health District to receive a COVID-19 vaccine.