Report Vaccination Issues

If you are attempting to secure the COVID-19 vaccine for yourself, a colleague, or a loved one, please complete the form below and, as possible, staff from IDHS will be in touch to support you.

You can call 1-833-621-1284 or visit CovidVaccination.DPH.Illinois.gov to register for the COVID-19 vaccination.

First Name:

Last Name:

Email:

Cell Phone:

ZIP Code:

Residence County:

Health Department:

Employer:

Occupation:

In what phase of the Illinois vaccine distribution plan do you believe you belong?
Phase 1a: Healthcare Personnel
Phase 1a: Long-Term Care facility staff and residents
Phase 1a: Other congregate care staff and residents
Phase 1b: Persons aged 65 years and older
Phase 1b: Frontline Essential Workers

Phase 1b+ (other than City of Chicago): Persons 16 and older with disabilities or underlying medical conditions
Phase 1c (City of Chicago): Persons 16 and older with disabilities or underlying medical conditions
Phase 1c (City of Chicago): Other Essential Workers
Additional Priority Group (other than City of Chicago): Higher education staff, government workers, and media
Additional Priority Group (other than City of Chicago): Restaurant staff, construction trade workers, and religious leaders
Phase 2: Persons 16 and older not included in previous phases

Please briefly describe the concern or delay you are experiencing related to the vaccine: