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COVID-19 Vaccination Request Form

March 19, 2021
Memorial Hermann is continuing to comply with the State’s guidance for COVID-19 vaccine distribution. This is the method that prioritizes vaccination in its Phase 1A, Phase 1B, and now Phase 1C for vaccine distribution.
 
Memorial Hermann has launched a digital COVID-19 Vaccination Request Form. All patients and members of the community 18 years of age and older can use this online tool to register for the opportunity to receive a COVID-19 vaccine from Memorial Hermann.  
 
Those who are interested in completing Memorial Hermann’s COVID-19 Vaccination Request Form are able to sign up here.
 
For answers to your general COVID-19 vaccine questions, please click here.