Note: The health department has asked residents not to fill out this survey right now. It has pressed "pause" on the process until it can get caught up with surveys already submitted.

Use the links here to register for vaccinations under Phase 1b, as determined by the Virginia Health Department. As vaccine becomes available, health department representatives will call those who have registered to arrange an appointment.

All persons aged 75 years and older that require assistance completing the online survey tool to be added to the list of RRHD residents that would like to receive COVID-19 vaccine may call 540-308-6072 to speak with a health department employee. (Anyone who has already filled out the survey should not call this number, as it will result in multiple entries)

Phase 1b vaccine survey for essential workers

Business owners or managers who employ essential workers -- those directly involved in public-facing, face-to-face interactions -- in the Rappahannock-Rapidan Health District (Culpeper, Fauquier, Madison, Orange or Rappahannock counties) may complete this survey to be placed on the list of employers requesting COVID-19 vaccinations for their staff.

This list includes categories of essential agencies that the CDC and VDH have considered for vaccination plans. This is not a complete nor final list. This survey does not guarantee vaccination.

  • Police, fire, hazmat
  • Corrections and homeless shelter workers
  • Childcare/K-12 Teachers/Staff
  • Food and agriculture (Food packaging and distribution)
  • Manufacturing
  • Grocery store workers
  • Public transportation workers
  • Mail carriers (USPS and private)
  • 911 emergency communications center
  • Local government officials 

Phase 1b vaccine survey for individuals

Anyone who is 75 years or older living in the Rappahannock-Rapidan Health District or who is living/coordinating services for those in a correctional facility, homeless shelter, or migrant labor camp and have a firm commitment to be vaccinated against COVID-19, may complete this survey to be placed on a vaccination list.

(This form is only to notify the health department of specific demographics. It does not automatically schedule a vaccination appointment.)

Source: Rappahannock-Rapidan Health District, Virginia Department of Health

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