COVID-19 vaccine appointment at Horizonte!
Horizonte will host a COVID-19 clinic on April 23rd and April 24th at our main site located 1234 S Main Street SLC, Utah 84101. Everyone 18 and older in our Horizonte community is eligible for this vaccine regardless of your immigration status. None of your information will be shared.
Choose Friday or Saturday - do not select times for both days. Your 2nd dose will be May 21st at the same time you select for your first dose.
Choose Friday or Saturday - do not select times for both days. Your 2nd dose will be May 22nd at the same time you select for your first dose.
First and Last Name(s)
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Other
Birthday
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Ethnicity (choose one)
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Hispanic/Latino
Non Hispanic/Latino
Race (choose one or more)
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America Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
More than One Race
What Languages do you speak?
*
The Utah Health Department with the Salt Lake City School District will need to contact you to complete your registration before your vaccine appointment. Do you give them permission to call you?
*
Yes, Utah Health Department can call me.
Submit
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