Thank you for your interest in the COVID-19 vaccine.
To make sure that vaccines are offered in a fair way, New Hampshire has set aside 10% of the available state vaccine supply for disproportionately impacted populations. People who belong to these groups are identified through the COVID-19 Community Vulnerability Index (CCVI).
UPDATE: Governor Sununu has announced all New Hampshire Residents, 16 years and older, will be able to register via vaccines.nh.gov or by calling 2-1-1 as of April 2, 2021. Please register via that process first if you are able. The process below is now most useful for homebound or homeless people, or those who have barriers to registering for an appointment through the state's website.
Can I get the vaccine through this process?
If you (or the person you are helping with this process) can answer yes to any of the following questions, you are eligible to receive the vaccine.
- Homeless: Are you currently experiencing sheltered or unsheltered homelessness?
- Homebound: Are you currently homebound? For instance, according to your primary care provider, could your health or illness worsen if you leave home? Do you require the help of another person and/or medical equipment to leave the home? Do you find it difficult to leave your home and typically cannot do so?
- Can't get to vaccination site: Do you have physical barriers that prevent you from traveling to the state vaccine sites (such as no transportation)?
- No phone or computer: Do you have limited access to register for a vaccine such as unreliable internet, no computer, or no phone to call 2-1-1?
- Limited English or communication: Do you have language or communication barriers that prevent you from understanding registration instructions?
- Poor health with no doctor: Do you not have a medical home or health care provider who can verify your medical conditions to be eligible for a vaccine?
- Low-income: Is your income below the federal poverty line (persons in family/household: 1 person - $12,880; 2 people - $17,420; 3 people - $21,960; 4 people - $26,500)?
- People of color: Do you identify as part of a racial or ethnic minority community (all persons except for white, non-Hispanic)?
I answered yes to a question above. How do I request an appointment?
If you answered yes above, you are eligible to get a COVID-19 vaccine.
To request a vaccine appointment, please enter your information on this form:
Then one of our volunteers will contact you within the next week to book your appointment.
How will I know you received the form?
When you complete the form, you will get a completion message at the end of the form. However, you will not receive a separate confirmation email.
Instead, your name has been put on a list for one of our volunteers to call you back within the next week.
How will someone contact me to schedule my vaccination appointment?
After you fill out the form linked above, someone will call the number you gave us to schedule your appointment. Your appointment may not be right away, and we appreciate your patience. A team of volunteers is working hard to help schedule appointments for thousands of people.
If the person eligible for vaccination is not reachable via phone, please list the contact information for the person or organization who can help us coordinate their vaccination appointment.
If you haven’t heard back from us in five (5) business days, please call 603-354-6712 and select option one to leave a message with your name and phone number requesting a callback.
Who manages the Community Vaccine Equity Allocation process?
The Greater Monadnock Public Health Network (GMPHN), which serves the 23 towns of Cheshire County and the ten western-most towns in Hillsborough County, manages vaccine distribution for our racial and ethnic minority community in the Monadnock Region.
What if I have more questions?
Here are some resources to answer your questions:
- Cheshire Medical Center Vaccine FAQS
- Monadnock Community Hospital Vaccine FAQS
- New Hampshire Vaccine Information