Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Preregister for East Hampton COVID-19 Vaccine

  1. FooterLogo-1

  2. vaccinate new york square

  3. Preregister for a COVID-19 Vaccine

    Sign up to be notified when vaccination appointments become available at the East Hampton Town Center for Humanity. At present, all New Yorkers over age 16 (for the Pfizer vaccine), or age 18 (for the Moderna and J&J vaccines) are eligible to be vaccinated.

  4. Please note this is NOT an appointment

    Pre-Registration does not schedule an appointment for you to get a vaccine. Once you pre-register, you will be notified when vaccination appointments become available, and receive further information on how to schedule an appointment.

  5. The Town of East Hampton receives a limited supply of COVID-19 vaccine doses from the State/County and can hold clinics only periodically. Due to high demand and very limited supply, there are a limited number of appointments available. Please keep in mind that it could take several weeks or longer to be contacted to schedule your appointment in East Hampton. To seek an appointment at another location, please refer to this list of vaccination sites: https://ehamptonny.gov/DocumentCenter/View/7849/Suffolk-County-Distribution-Sites-22021

  6. Leave This Blank: