COVID-19 Vaccine Waitlist


To be added to the COVID-19 Vaccination waitlist, please visit the link below and complete the form. If you are registering multiple people, please complete the registration form for each individual.

COVID-19 Vaccine Registration Form

Please read before submitting registering:

  1. Community Family Health Center receives a limited supply of vaccines and we are distributing them according to the guidelines established by the Ohio Department of Health.
  2. If you have been scheduled to receive the COVID-19 vaccine with another agency or pharmacy, do not accept an appointment at Community Family Health Center.
  3. If you are unable to keep your vaccination appointment, please call the health center at 330.365.1781 right away.
  4. Our office staff will call you when it is your turn to receive the vaccine. Please refrain from calling our office to ask about your position on the waitlist.
  5. Please only fill out and submit the form once.