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The original item was published from 2/16/2021 10:18:00 AM to 2/25/2021 5:43:09 PM.

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Posted on: February 5, 2021

[ARCHIVED] Chickahominy Health District COVID-19 Vaccine Sign-Up Survey

Chickahominy Health District - COVID-19 Vaccine Inquiry Form

*** An important update to the COVID-19 vaccination pre-registration process***

The Commonwealth of Virginia is launching a Statewide Vaccine Pre-Registration System to provide a unified and comprehensive process for people in Virginia to pre-register for the COVID-19 vaccine. As a result, the Virginia Department of Health has directed all local health districts, including the Chickahominy Health District, to close their pre-registration forms and surveys at 5 p.m. on Friday, February 12, and replace them at 8 a.m. on Tuesday, February 16 with a link to the new statewide system at vaccinate.virginia.govIn the interim, existing waiting lists will be imported to the new system and pre-registration will be temporarily unavailable throughout Virginia. 

All individuals who have previously filled out a survey or form or signed up for a waitlist to be vaccinated through their local health district will be automatically imported into the new statewide system. Individuals will maintain their current status in the queue, and will be able to search that they are in the new system starting Tuesday morning.

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How can you register for the COVID-19 Coronavirus vaccine?


At this time those who are eligible for the COVID-19 vaccine under Phase 1a and Phase 1b can sign up in one of three ways.

  1. COVID-19 Vaccine Sign-Up Survey: Eligible individuals can complete the new Statewide Vaccine Pre-Registration tool on Tuesday, February 16th.  The Chickahominy Health District’s COVID-19 online vaccine sign-up survey tool, which can be found here: https://forms.gle/fS8wcHMeBej1gMpA8, is no longer active.  If you previously completed the Virginia Department of Health’s “When Can I Get Vaccinated” online tool, then there is no need to register again.  
  2. Chickahominy Health District Hotline: If you prefer to speak to someone, you can call and sign-up over the phone using the new Statewide Vaccine Pre-Registration tool on Tuesday, February 16th.  The telephone number for the Chickahominy Health District's COVID-19 call center can be reached at (804) 365-3240.  
  3. Goochland County 65+ Hotline: Goochland County has a dedicated hotline mailbox to help residents Age 65+ and those who are unable to complete the online sign-up survey due to lack of technology access. Goochland's hotline can be reached at (804) 556-5828, residents will need to leave a message and a volunteer will call you back. 

The health departments vaccine supply is currently limited, and they are doing their best to serve you and your loved ones. After you register and vaccine is available, someone from the health department will contact you to schedule your vaccination appointment once it is your turn.

Have questions about the COVID-19 Vaccine? Check out the Virginia Department of Health’s FAQs at https://www.vdh.virginia.gov/covid-19-faq/vaccination/ or contact the Chickahominy Health District at chdvaccine@vdh.virginia.gov or call (804) 365-3240.

If you are a resident of Henrico County or the City of Richmond you can find information about the Henrico Health District at https://henrico.us/health/ and information about the Richmond City Health District at https://www.vdh.virginia.gov/richmond-city/.  If you have vaccine questions call their COVID-19 hotline at (804) 205-3501 or email RHHDvax@vdh.virginia.gov

COVID-19 Vaccine Sign-Up Survey Tool
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