COVID-19 Vaccine Pre-Registration

We are now scheduling COVID-19 vaccination appointments for NATIVE HEALTH patients! 
If you are a NATIVE HEALTH patient of record in either Medical, Dental or Behavioral Health and/or a client of record in a NATIVE HEALTH program such as Health Start, Home Visiting, WIC, Community Garden, Senior Food Box Program, Arizona Long Term Care (ALTCS), or other NATIVE HEALTH Program and part of phases 1A, 1B, and 1C, you might be eligible to receive the COVID-19 Vaccine.  Appointments will be available and will be limited to vaccine supply. 
Please complete the form below and we will be in touch to schedule your COVID-19 vaccine appointment. 
By completing this form, you are agreeing that NATIVE HEALTH may send you a registration request at the email address you provide on this form, that you understand that NATIVE HEALTH cannot guarantee the security of the messages it sends and that there is a risk the message may be intercepted and read by a third party.
  • OR

  • We will confirm that you are a client and/or patient of record with active involvement before contacting you. Please keep watching our website and social media for updates on vaccines for Essential Workers in Group 1B. We appreciate your patience.