Vaccination Priority Form
Dear UMB Community,
Although the University of Maryland, Baltimore (UMB) is not in possession of COVID-19 vaccines nor responsible for the allocation of vaccines, we are conducting a UMB-specific survey to ensure that all at UMB are properly classified in the event that vaccines become available for our faculty, staff, and students.
To access the survey form, please click here. This link is intended for the recipient of this email only and should not be forwarded or shared with anyone else. The information collected will be protected and is solely for classifying priority.
UMB cannot guarantee that anyone at UMB will be vaccinated by virtue of completing this form. Instead, we want to be prepared if the opportunity becomes available. If you find that you have the opportunity to get the vaccine elsewhere, please do so. The more people who get vaccinated, the safer we will all be and the faster we can be rid of this terrible virus.
Stay healthy and safe.
Sincerely,
Bruce E. Jarrell, MD, FACS
President
FAQs
Q: Who should fill out this form?
A: All members of the UMB community (students, staff, and faculty) who received this form directly should complete it. This form is a tool to put members of the UMB community into their appropriate vaccine priority groups based on Maryland Department of Health (MDH) guidelines. Some questions are unique to UMB functions. This form should not be used by individuals who are not part of the UMB community.
Q: Does filling out this form mean that I will receive an appointment to get vaccinated through UMB?
A: Not necessarily. UMB is working closely with the University of Maryland Medical Center (UMMC) to ensure that any individual in Phase 1A of the Maryland COVID-19 Vaccination Plan are vaccinated as quickly as possible, if they would like to be vaccinated. UMB’s ability to facilitate vaccine appointments for individuals in other priority groups and phases will depend on whether MDH provides UMMC with access to the vaccine for this purpose.
Q: How do I know which vaccine priority group I will be placed in?
A: You will be placed into the highest appropriate vaccine priority group based on your responses to the questions on the form. Vaccine allocations are based on the Maryland COVID-19 Vaccination Plan and information provided by Gov. Larry Hogan related to the rollout of vaccines. These plans, and therefore your designated vaccine priority group, are subject to change.
Q. What if I already have an appointment for a vaccine?
A. Please complete this form and keep your scheduled vaccination appointment. If you were notified by UMMC that you are approved for vaccination and need to reschedule your appointment, you may do so here.
