COVID-19 Vaccination

The Blue Ridge Health District (BRHD) is working diligently on COVID-19 vaccination plans for the district. Currently BRHD vaccine distribution is limited to Phase 1A Frontline Healthcare workers and Phase 1B Essential Workers and Individuals 65+ and those ages 16-64 with high risk medical conditions. Vaccines will be made available to the various populations identified in the phased distribution plans established by CDC's Advisory Committee on Immunization Practices and Virginia Department of Health (VDH).

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*IMPORTANT: BRHD surveys are NOT scheduling you for a vaccine. These surveys are the first step in getting a vaccine. These surveys are to capture your information and BRHD will contact you when it's time to schedule an appointment to get vaccinated.*

If you are a healthcare entity defined as those directly engaged in the care and/or interactions with patients face to face in the settings listed below in the in the Blue Ridge Health District (BRHD) please complete this form to be placed on our list for your STAFF to receive a COVID-19 vaccine. This is NOT for Long-Term Care Facilities, Assisted Living Facilities, or First Responders. These groups have already been accounted for. BRHD includes Albemarle, Charlottesville, Fluvanna, Greene, Louisa, and Nelson.

  • Behavioral health provider
  • Community health workers
  • Dental assistants, hygienists, dentists
  • EMT/First responders
  • Environmental services staff
  • Healthcare trainees
  • Home health workers
  • Human service providers
  • Infection control and quality assurance
  • Laboratories
  • Mortuary service providers
  • Nurses, nursing assistants
  • Optometrists
  • Pharmacists, pharmacy techs, and staff
  • Physicians, physician assistants
  • Public-facing public health workers
  • Radiological techs
  • Respiratory, physical, speech, and occupational techs
    Social workers

This form is only for healthcare provider groups to notify the Health Department of your workplace specifics and how many healthcare staff you have that would need to be vaccinated against COVID-19. This does NOT guarantee COVID-19 vaccines. We will be in touch with more information as it becomes available.

Read all of the information on the survey before you submit your responses. When you complete this survey, you will receive a confirmation email. THIS WILL BE THE ONLY CONFIRMATION AVAILABLE. We will be in touch with you when we have additional vaccine information.

 

 

If you are an business owner/manager who employs essential workers as defined as those directly engaged in public facing, face-to-face interactions (see list below) in the Blue Ridge Health District (BRHD) please complete this form to be placed on our list of employers requesting COVID-19 vaccines for staff. BRHD includes Albemarle, Charlottesville, Fluvanna, Greene, Louisa, and Nelson.

  • Police, Fire, Hazmat (who weren’t already identified in Phase 1A)
  • Corrections and homeless shelter workers
  • Childcare/K-12 Teachers/Staff
  • Food and Agriculture (Food Packaging and Distribution)
  • Manufacturing
  • Grocery Store Workers
  • Public Transportation Workers
  • Mail carriers (USPS and private)
  • 911 Emergency Communications Center

Individuals who complete this form will receive follow up communication to schedule an appointment as soon as available. This form will be the fastest way to get an appointment but the timeline for an appointment is TBD.

This form is only for essential employers to notify the Health Department of your workplace specifics and how many public facing staff you have that would need to be vaccinated against COVID-19. This does NOT guarantee COVID-19 vaccines. We will be in touch with more information as it becomes available.

Read all of the information on the survey before you submit your responses. When you complete this survey, you will receive a confirmation email. THIS WILL BE THE ONLY CONFIRMATION AVAILABLE. We will be in touch with you when we have additional vaccine information.

If you are 65 YEARS OR OLDER living in the Blue Ridge Health District OR are LIVING/COORDINATING SERVICES for those in a correctional facility, homeless shelter, or migrant labor camp and have a FIRM commitment to be vaccinated against COVID-19, please complete this survey to be placed on our vaccine list. The Blue Ridge Health District includes Albemarle, Charlottesville, Fluvanna, Greene, Louisa, and Nelson.

  • Individuals ages 65+ that live in Albemarle, Charlottesville, Fluvanna, Greene, Louisa, and Nelson.
  • Individuals living or coordinating services for those in a correctional facility, homeless shelter, or migrant labor camp.

This form is only to notify the Health Department of your specific demographics. This is NOT scheduling an appointment. We will be in touch with more information as it becomes available, which could be awhile, and next steps for how you can schedule an appointment. 

Read all of the information on the survey before you submit your responses. Important to note:
.  Fill in all of the blanks. Do not request editing access to this survey.
.  When you complete this survey, you will receive a confirmation email. THIS WILL BE THE ONLY CONFIRMATION AVAILABLE. Please check your SPAM and promotions folders for this confirmation email.
.  We will be in touch with you when we have additional vaccine information.

Fase 1B: para PERSONAS 65 y mayores

Si tiene 65 AÑOS O MÁS y vive en el distrito de salud de Blue Ridge, por favor complete este encuesta para inclusión en nuestra lista de vacunas de COVID-19. El distrito de salud de Blue Ridge incluye Albemarle, Charlottesville, Fluvanna, Greene, Louisa y Nelson.

Haga clic aquí para completar la encuesta de vacunas COVID para individuos de la fase 1B.

  • Este formulario es solo para notificar al departamento de salud de sus datos demográficos específicos. Nos pondremos en contacto con más información a medida que esté disponible, lo que podría ser dentro de varios meses.
  • Complete todos los espacios en blanco. No solicite acceso de edición a esta encuesta.
  • Cuando complete esta encuesta, recibirá un correo electrónico de confirmación. ESTA SERÁ LA ÚNICA CONFIRMACIÓN DISPONIBLE.
  • Nos comunicaremos con usted cuando tengamos más información sobre vacunas.

Fase 1B: para PERSONAS de 16 a 64 años con condiciones médicas de alto riesgo

Si tiene entre 16 y 64 años Y TIENE UNA CONDICIÓN MÉDICA DE ALTO RIESGO (según la definición de los CDC) y vive en el distrito de salud de Blue Ridge, por favor complete esta encuesta para ser incluido en la lista de personas que desean recibir la vacuna contra el COVID-19. El distrito de salud de Blue Ridge incluye Albemarle, Charlottesville, Fluvanna, Greene, Louisa y Nelson.

Este formulario es solo para notificar al departamento de salud de sus datos. Nos pondremos en contacto con usted con más información a medida que esté disponible.

Haga clic aquí para completar la encuesta de la vacuna contra COVID para individuos de 16-64 con alto riesgo. Lea toda la información de la encuesta antes de enviar sus respuestas. Es importante tener en cuenta:

  • Complete todos los espacios en blanco.
  • Cuando complete esta encuesta, recibirá un correo electrónico de confirmación. ESTA SERÁ LA ÚNICA CONFIRMACIÓN DISPONIBLE.

Nos comunicaremos con usted cuando tengamos más información sobre los próximos pasos.

 

If you are age 16 to 64 WITH A HIGH RISK MEDICAL CONDITION (as defined by the CDC) living in the Blue Ridge Health District (BRHD - Albemarle County, City of Charlottesville, Fluvanna County, Greene County, Louisa County, and Nelson County) with a FIRM commitment to receiving the COVID-19 vaccine please complete this survey to be placed on our vaccine list. Please speak with your healthcare provider individually before completing this form to see if you should receive a COVID-19 vaccine.

This form is only to notify the Health Department of your specific demographics. This is NOT scheduling an appointment. We will be in touch with more information as it becomes available, which could be awhile, and next steps for how you can schedule an appointment. 

https://forms.gle/VL5chERLeXzSDRCK9

Read all of the information on the survey before you submit your responses. Important to note:
.  Fill in all of the blanks. Do not request editing access to this survey.
.  When you complete this survey, you will receive a confirmation email. THIS WILL BE THE ONLY CONFIRMATION AVAILABLE. Please check your SPAM and promotions folders for this confirmation email.
.  We will be in touch with you when we have additional vaccine information.

Visit our Job and Volunteer Opportunities webpage for the latest COVID-19 RN postings and volunteer information.

BRHD COVID-19 Vaccination Updates:

  • January 15, 2021: BRHD Announces Phase 1B Plans
  • January 14, 2021: Governor Northam expanded Phase 1B criteria to include individuals over age 65 and individuals aged 16-64 with certain medical conditions. BRHD will release plans for Phase 1B rollout on Friday, January 15.
  • January 8, 2021: BRHD has moved to vaccinating all individuals in Phase 1A.
  • January 7, 2021 BRHD Vaccination Update - New Surveys for Phase 1 B essential workers and individuals aged 75+.
  • December 31, 2020 BRHD Vaccination Update - Rollout for Phase 1 A vaccine distribution underway with prioritizing EMS, Region Ten residential facility staff, and dialysis centers.
  • It's likely that COVID-19 vaccines won't be available to the general public until summertime.
  • Although some may be getting a COVID-19 vaccine now, everyone is encouraged to continue safe practices to prevent the spread of COVID-19. Continue to wear cloth face-coverings or masks, stay at least six feet away from others, wash your hands well and often, and avoid gatherings with anyone who is not a member of your household.
  • Visit the VDH COVID-19 Vaccine Website for the latest COVID-19 Vaccination Plans and vaccine information.
  • Questions about the COVID-19 Vaccine? Visit the VDH FAQ website