Jackson County is in the High Risk category for COVID-19 as of February 26. Visit the Governor's website for information on what is allowed during this time. Get general updates, vaccine information, and resources related to the Coronavirus (COVID-19) pandemic here.
 

COVID-19 Vaccine Interest Form

Vaccine Interest Form for Ashland Residents 65+

NOTE: If you already contacted Ashland Senior Services (Ashland Senior Center) via phone or email to get on a vaccine list, please do not complete this form.  It will just cause duplication and delay our ability to help you. 

Ashland Senior Services Division is maintaining a list of seniors seeking the COVID-19 vaccine. If you are an Ashland resident 65 years or older please fill out the form below. As vaccine appointments arise at various local clinics, we will contact the people on our list.  
Update: As of 3/29/21, Ashland residents age 45-64 with an underlying condition are also eligible and may sign up on this list. 

Jackson County seniors and people with disabilities who live outside of Ashland should call the Aging and Disability Resource Connection (ADRC) at 541-618-7572 to get on their list instead. We are working together, so there is no need to get on both lists.

* DO YOU HAVE TRANSPORTATION TO AND FROM THE VACCINE APPOINTMENT? (Mark No if you need help with transportation)
* CAN YOU ATTEND AN EVENING APPOINTMENT?
* CAN YOU ATTEND A WEEKEND APPOINTMENT?
 
 
* WOULD YOU WANT AN APPOINTMENT OUTISDE OF ASHLAND, IF AVAILABLE?
* DO YOU GIVE APRC PERMISSION TO SHARE YOUR INFORMATION CONFIDENTIALLY WITH ANOTHER AGENCY THAT IS DOING THE SCHEDULING OR VACCINATING?
Thank you for completing the COVID-19 Vaccine Interest Form. Due to heavy volume, please do not call for updates. You will be contacted when an opening for you becomes available. 

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