Online VAMS Enrollment

(for Eligible Individuals)

A doctor administering the vaccine to a patient's arm.

Please Note:

This form is optional and is only for requesting enrollment with the Vaccine Administration Management System (VAMS).

You do not need to register with VAMS if you have other options for getting the vaccine.

Form Instructions

Please visit: CT COVID-19 Vaccine: Phases and Eligibility to see if you are eligible to register in Vaccination Administration Management System (VAMS).

  • Johnson & Johnson vaccine is available for individuals ages 18 and older. 
  • Moderna vaccine is available for individuals ages 18 and older.
  • Pfizer vaccine is available for individuals ages 16 and older.
    • At the time of the vaccine appointment, minors (ages 16-17) should be accompanied by a parent or legal guardian to consent to the vaccine. Or, if you will not accompany the minor, the parent/guardian will need to contact the provider scheduled to administer the vaccine to get direction on what will be needed to confirm adult consent for the vaccination. If a minor arrives at their appointment without a parent or guardian and you have not consulted the provider to know what is needed, they may not be able to be vaccinated.

  • If you are eligible to register, please complete this form below to request enrollment in VAMS.
  • You will need to enter your full name, date of birth, eligible occupation or Age eligibility, Zip Code and email address. The information you enter will only be used for purposes of scheduling your vaccination, and it will be kept private.
  • You will receive a confirmation number after you have submitted your enrollment. Then, within 24-48 hours, you will receive an email from VAMS "" or "" with a link to complete your registration and schedule your appointment for COVID-19 vaccination.

* - Required Field