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Community Health Care Worker Covid-19 Vaccine Registration

The State of Vermont is currently directing that health care workers in hospitals and community practices that meet the State identified tier 1A criteria (as noted in this Health Advisory Alert), be prioritized for COVID-19 vaccination. At this time, vaccinations are being administered by all hospitals in the state for their own employees, as well as health care workers in their services areas. Porter Medical Center is operating a vaccine clinic for community health care workers who have direct patient contact.

Where to Start

In order for us to begin the scheduling process of your staff, please fill out this form.

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How to Fill Out the Form

**To expedite processing of your information, please do not modify the columns or rows in the spreadsheet**

  • Please use this spreadsheet to input information about your staff who meet the tier 1A criteria identified by the State of Vermont because they are health care providers and staff who have direct patient contact as noted in this Health Advisory Alert). Given the State’s criteria, the limited supply of vaccine, and the varying levels of risk, it is not possible to predict when all staff will get vaccinated.
  • Sign the attestation on the form before submitting. 
  • Email the completed form to

Next Steps

Once your information is submitted, we will contact you directly to confirm eligibility and provide scheduling instructions. At this time, all appointments will be made directly through the Vermont Department Health online appointment system (Your password to schedule must be obtained by filling out the form above)


For help or technical assistance with account registration issues or questions about the Vermont Department of Health Online Portal, please contact the technical support line at 1-802-863-7240.