SUMMITCOUNTY Email Marketing -

This is the official Summit County (UTAH) COVID-19 vaccine signup form.

Currently open to individuals 18 years or older. Summit County vaccine clinics currently have Moderna and Johnson and Johnson (18+) vaccines. Individuals 16-17 years of age must register for the Pfizer vaccine at a participating Wasatch Front clinic.

NOTE: Each person who completes this form must have a separate email address (couples cannot sign up with the same email address).

This is a pre-registration form and does not book an appointment for you.
You can expect an email from the CDC to schedule your vaccination appointment within 1 week.
You will be notified by phone & email when it is your turn to schedule a vaccine appointment. Due to a shortage of vaccines, this process may take up to 4 weeks.
Questions? Call the Summit County COVID-19 Hotline at
435-333-0050 during regular business hours.

For UTAH residents ONLY:

First Name*

Last Name*

Email*

Phone*

Address*

Zip Code*

What is your age?*

Do you live with someone who would like to receive the vaccine at the same time as you if possible?*

Yes

No