COVID-19 Vaccination Waitlist Request Form

Safe, tested and effective – the COVID-19 vaccine is one more way to stay healthy.

The COVID-19 vaccine will be available to all who want it, but supplies will be limited at first. Duke Health is following NC DHHS guidelines for COVID-19 vaccination distribution starting with vaccinating those most at-risk for severe illness, and then expanding access to vaccination to more people as the supply increases throughout 2021. Moving to new phases is at the discretion of NC DHHS, and you can learn more about where you fit in the state COVID-19 vaccine distribution timeline here.

You do not need to be a current Duke Health patient to be vaccinated at Duke. If you are interested in joining our COVID-19 vaccine waiting list, please complete the form below.

NOTE: If you are having a life-threatening medical emergency, please call 911 or proceed to the nearest emergency room. For urgent care needs, please visit a Duke Urgent Care clinic.

Thank you for your interest in the COVID-19 Vaccine and for choosing Duke Health.

Thank you for your interest in receiving the COVID-19 vaccine. If you currently meet the state's criteria to be vaccinated at this time, please complete the form below to request your first dose of the vaccine. Please only submit this form if you are already eligible to receive the vaccine.

If you are a Duke MyChart user, please check your Duke MyChart account to see if you are able to schedule your appointment for vaccination online.

As the state approves more people to be eligible for vaccination, we will provide more information and instructions for scheduling your appointment.