COVID-19 Vaccine

Vaccine Registration and Scheduling

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Now scheduling COVID-19 vaccination for the general public.

A safe and effective COVID-19 vaccine plays a critical role in providing protection against the virus, preventing severe illness and saving lives.

IF the vaccine recipient will be UNDER 19 on the date of receipt, AND a parent/legal guardian WILL NOT be present, completion of these consent forms is REQUIRED.
Print and fill out COVID-19 Vaccine Consent Form with examples

COVID-19 Vaccine Information
Get Vaccine Fact Sheets and Frequently Asked Questions. Learn about the COVID-19 Variants plus other resources for you and your family.

Schedule a FIRST dose appointment
LLCHD is currently providing first doses to anyone who falls within the current CDC recommendations and is offering Pfizer and Moderna First doses.

Schedule a SECOND dose appointment
LLCHD is currently providing second doses to anyone who falls within the current CDC recommendations and is offering Pfizer and Moderna Second doses. People who are immunocompromised may also Schedule a THIRD dose appointment based on the CDC recommendations.

Schedule a BOOSTER dose appointment
LLCHD is currently providing booster doses to anyone who falls within the current CDC recommendations and is offering Pfizer and Moderna booster doses.

Homebound Residents or Children under 5
If you are homebound and need accommodations, click here to register or call 402-441-4200 for assistance.
If you are under five years of age, click here to register or call 402-441-4200 for assistance.

Please schedule your vaccination by filling out the form below.

Group:

Company/School: Public

Please Enter Your Information
First Name: *
Last Name: *
Date of Birth: * m/d/yyyy
All minor children 18 years of age and younger must be accompanied by a parent, court-appointed guardian or an authorized agent.

Gender: *
Race: *
Ethnicity: *

Please check if you are experiencing homelessness or have an unknown address:

Address:

City: *
State:
Zip: *

Do you have a mobile phone? Yes
Home Phone: (000) 000-000
Work Phone: (000) 000-000
Preferred Phone: *
Email:
Do you need an interpreter? Yes including Sign Language

Do you think you have a weakened immune system? Yes

Do you have any comments, concerns or if you need any accomodations:

View upcoming clinics by picking your preferred vaccine
Preferred Vaccine: Pfizer
Moderna *

First Name Required
Last Name Required
Date of Birth Required
Gender Required
Race Required
Ethnicity Required
Address Required
City Required
Zip code Required
Preferred Phone Required
Preferred Vaccine Required

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