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Interested in receiving the COVID-19 vaccine? CLICK HERE to fill out our vaccine interest form.
Public Health

Vaccine Interest Form

Submitting this form does not guarantee availability of COVID-19 vaccine. However, it will allow us to notify you when the vaccine is available and provide you with information on scheduling an appointment. You only need to fill out this form once to be added to our waitlist. 

Vaccine administered in Jones County is manufactured by Moderna. This vaccine is only approved for individuals 18 years and older. It is administered via two injections at least 28 days apart. 

COVID-19 Vaccine Information

 

All fields are required.

  4. If you do not have an email address, type None.
  11. Healthcare Provider
    First Responder (Fire, Law Enforcement)
    Congregate living organization (staff or client)
    Education (teachers, school staff, daycare)
    Food & Agriculture
    Manufacturing
    Corrections worker
    US Postal Service
    Public Transit
    Grocery store worker
    Transportation & Logistics
    Food Service
    Shelter & Housing
    Finance
    IT & Communication
    Energy
    Media
    Legal
    Public Safety (Engineers)
    Water & Wastewater
    Person with disability/Caregiver to person with disability
    Not applicable, retired or unemployed
    Other

Resources & Services

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Map · Jones County Public Health

105 Broadway Pl. · Anamosa, IA 52205

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