COVID Vaccine Sign Up Sheets

These COVID Vaccine sign up sheets were created to help organize and implement a notification system for individuals interested in receiving the COVID vaccine. Due to the limited availability of the vaccine, it is being released in phases. These lists serve to condense information of who would be interested in the vaccine, and provides their contact information. This will allow administration to notify these individuals when their phase has been rolled out, and will allow notification of the steps they need to take in order to receive the vaccination.

The indication tab was listed in the event that the phases change their requirements, they could be easily sorted into their new phase. Our office relies primarily on telephone communication, but you could easily use Email to distribute this information as well.

I have included a template for those in North Carolina that is filled out with the phase as well as a description, as well as a BLANK TEMPLATE that you can fill in depending on your own state's phases and implementation strategy. The phases are color coordinated to help with visibility.

I've also included some blank sign up sheets, color coded by phase so you can add that as filler to your list for as many pages as you need.

There are four different phase colors and you could make as many subgroups as you would like.

The sheets are free, but any donations to my coffee fund are always greatly appreciated!

Thanks!
Liz