COVID-19 Vaccine Interest Form

The COVID-19 vaccines give us hope that we will soon be able to get back to seeing friends, family, and loved ones. While Independence Blue Cross (Independence) does not control the vaccine supply, we have been teaming up with providers to be able to offer appointments exclusively to Independence members.

To be notified of a vaccine appointment opportunity, enter your contact information below. We will reach out to you when the time is right, based on eligibility criteria, where you live, and the opportunities we have in your area.

Y0041_HM_97329_2021 Website last updated: 3/30/2021