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COVID-19 Vaccine Standby List Cancellation Form

  1. Please complete this form to be removed from the County's COVID-19 Vaccine standby list.

  2. Thank you for letting us know you were able to secure a COVID-19 vaccine appointment through a pharmacy, provider's office, or a health department clinic! You are helping to ensure our clinics are able to run as smoothly and efficiently as possible.

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  4. This field is not part of the form submission.