Penn Medicine COVID-19 Vaccine Interest Form

Penn Medicine is currently offering the Pfizer-BioNTech vaccine to anyone age 12 and older, the Moderna vaccine to anyone age 16 and older, and the Johnson & Johnson vaccine to adults who are homebound. All three vaccines are 100% effective at preventing hospitalizations and deaths from COVID-19 in tens of thousands of clinical trial participants. If you are eligible to receive the COVID-19 vaccine, we encourage you to get it, or to speak with your provider if you have questions about side effects and whether it's right for you.

If you would like to schedule a COVID vaccine appointment* at Penn Medicine, please call our vaccine scheduling hotline at 267-758-4902. We answer calls between 8am and 5pm on Monday through Friday. View locations and hours information on our vaccine website.

* Please note: Currently, we are not scheduling third doses by phone, but we soon will for patients with severely weakened immune systems.

If you would like us to keep you informed about COVID vaccine efforts at Penn Medicine, please complete the form below.

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Thank You

Thank you for your interest in a COVID-19 vaccine at Penn Medicine. Please note that we currently have a limited supply of vaccine and are vaccinating patients who are most at-risk of serious illness from COVID-19 first.

We will keep you informed as our vaccine distribution plan develops and our supply increases. Please note that we are unable to schedule vaccine appointments for patients who call us at this time. We understand how important it is to you to receive a vaccine and are doing everything we can to vaccinate as many people as we can, as quickly as we can.

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