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The Miami County COVID-19 Vaccination Interest Form is now available for anyone 12 years of age and older to fill out. The interest form is used to gather information from individuals in all phases for those interested in receiving a COVID-19 vaccine (Moderna, Pfizer or Janssen, J&J). Once submitted, Miami County Health Department staff will use the interest form to contact you with information to schedule your vaccination appointment. If you, or someone you know is home-bound and unable to travel to make a vaccine appointment, we are currently scheduling in-home vaccine appointments. ***Please note*** Do not call to see where you are at on "the list", if you submit an interest form via online submission, you will receive a confirmation email. If you do not receive a confirmation, please ensure the survey was submitted appropriately. If you have difficulty filling out the online form, or do not have access to internet, please call Miami County Health Department Monday-Friday 8:00-12:00; 1:00-4:30 at: 913-294-2431 and we would be happy to assist you in filling out the interest form.Please email: firstname.lastname@example.org with any questions or concerns regarding COVID-19.