This form is intended to be filled out by individuals who live or work in Oak Park and are eligible to receive a COVID-19 vaccine under the state's vaccine distribution plan.
Oak Park’s pre-registration form is now open to individuals age 16 and older who fit any one of the following categories:
- Individuals age 65 and older
- Frontline essential workers (teachers, licensed daycare staff, grocery store clerks, pharmacy workers, transit employees, mail carriers, delivery drivers)
- Essential workers (government workers, higher education, media, religious leaders, restaurant workers, trades people)
Phase 1b plus
- Individuals age 16 to 64 with a high-risk medical condition. High-risk medical conditions include cancer, COPD (Chronic Obstructive Pulmonary Disease), diabetes, heart conditions, immunocompromised state from a solid organ transplant, kidney disease, obesity, pregnancy, pulmonary disease, sickle cell disease
All Other Oak Park Residents
- Any resident aged 16 and older who wishes to be vaccinated and is not eligible in the categories above.
As vaccine supply remains limited, the Oak Park Public Health Department will continue to prioritize those eligible in Phases 1a, 1b and 1b plus before moving to all other residents.
Proof of age, residency and/or employment as a essential worker will be required at all Phase 1b vaccine clinics hosted by the Oak Park Department of Public Health.
For households with more than one eligible individual, each person should complete the form separately.
For your security, click on EXIT when done.