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The original item was published from 1/5/2021 8:08:16 AM to 1/6/2022 12:00:02 AM.

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Posted on: January 5, 2021

[ARCHIVED] Fishers Health Department Asks Residents to Complete COVID-19 Vaccine Interest Form

Fishers Health Department

The Fishers Health Department today released its COVID-19 Vaccine Interest Form in anticipation of receiving the Moderna vaccine in January. Public Health Director Monica Heltz requests residents to complete the interest form as quickly as possible.

The purpose of the interest form is to provide information to the Fishers Health Department to assist in the preparations of COVID-19 vaccination distribution. COVID-19 vaccinations are not anticipated to be available to the general public until mid-2021 but certain individuals may qualify to receive the vaccine sooner based on certain criteria. This survey is based on the most current criteria being utilized at the state and national levels for vaccine allocation and may change as new guidance is released to FHD.

Residents may access the Interest Form by clicking here or visiting Residents are encouraged to follow Fishers Health Department on Facebook and Twitter for the latest updates and to sign up for the weekly Fishers Health Department info updates at

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