COVID-19 Vaccination Survey

The Kent County Health Department (KCHD) is currently vaccinating individuals within Phase IA and Phase 1B. Please carefully review the criteria to ensure you are eligible to receive the vaccine before completing the survey below.

At this time, appointment availability is limited due to the supply of vaccine. Following completion of this survey, a Kent County Health Department representative will call you as vaccination appointments become available. Please note: this may take several weeks before you are called to schedule an appointment.

In order for the COVID-19 vaccine to be effective, it is recommended that individuals receive a second dose no earlier than 21-28 days after their initial vaccination, and from the same manufacturer. For that reason, it is important that you are available during that time frame.

Vaccinations for the Kent County Health Department will be administered at 700 Fuller Ave. NE in Grand Rapids. If you would like assistance in completing this form, please call 616.326.6992.

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