Seniors Vaccine Sign-up

for Senior 65+ only

If you are 65 years or older,
are a New York resident,

have not received a COVID-19 vaccination, and interested in getting vaccinated, please fill out the form below and we will submit your name for you.
Notice: Entering your information to our site DOES NOT guarantee you will receive a COVID-19 vaccination.

*Please fill out the form only one time.

COVID Vaccines