Fayette County COVID-19 Vaccine | Nicholas County Health Department

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One Stevens Road, Suite 201

Summersville, WV 26651

304-872-5329

Fax: 304-872-5362

Mon - Fri: 8:30 - 4:30

Closed Sat and Sun

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Home
Environmental
Health & Safety
- Preparedness Training
- Public Emergency Notification System
Clinical
Resources
Events
Contact Us
Online Payments

Fayette County COVID-19 Vaccine Registration

Name*
First Last
Date of Birth*
Gender
- Female
- Male
Race
- White
- Black/African American
- Asian
- Native Hawaiian/Pacific Islander
- American Indian/Alaskan Native
- Unknown
- Other
Ethnicity
- Not Hispanic/Latino
- Hispanic/Latino
- Unknown
Phone*
Email
Address*
Street Address City State ZIP Code
I consent to text messages about my registration on the mobile number provided. I hereby declare that all the given information are accurate.*
- Yes
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1 Stevens Road, Suite 201
Summersville, WV 26651

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Phone: (304) 872-5329
Fax: (304) 872-5362

Monday-Friday: 8:30 a.m. – 4:30 p.m.
After Hours Emergency: CALL 911

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