Home > Our Services > Coronavirus (COVID-19) > Register your interest for a COVID-19 Vaccine

Register your interest for a COVID-19 Vaccine

Step 1: Use the COVID-19 Vaccine Eligibility Checker to find out if you are in a Phase 1b priority group.

Step 2: Register your interest by completing the SHR Vaccination Registering Form.

Step 3: Download, print and complete a Vaccine Consent Form.

Step 4: Deliver your completed consent form to either Stawell Medical Centre or Building A, SRH Hospital reception.

Be prepared for SRH to contact you to arrange your appointment. Please note: Appointment times will depend on the number of available vaccines.

COVID-19 Vaccine Registration of Interest

Eligible people from the local community are invited to register an Expression of Interest to receive the COVID-19 vaccine at Stawell Regional Health.

Step 1 of 2

Name*
First Last
Phone*
Email
Home Address*
City County / State / Region ZIP / Postal Code

Confirm your eligibility as a local resident to receive a COVID-19 vaccine at Stawell Regional Health