COVID-19 Vaccine Survey

Stopping the spread of COVID-19 is a team effort, and that's why MU Health Care, Boone Health and Columbia/Boone County Public Health and Human Services are working together to vaccinate our community.

Here's how it works:

We are committed to treating all people who want the vaccine equally, regardless of whether they are MU Health Care or Boone Health patients or patients of other hospitals and health systems in our region.

  • Complete the survey by filling out the fields below, or call (573) 771-CARE (2273) to have someone fill it out and submit for you.
  • Based on your responses, you will be sorted into the appropriate tier (as determined by the state of Missouri).
  • As we receive vaccine supply, we will open appointment spots based on the number of doses we receive.
  • We will then use a process to select people from eligible tiers and offer them appointment invitations* via phone or email.
    • The process involves assigning a random number to each survey submission and then adding points for length on the survey list.
    • We also try to group couples whenever both people are eligible and in the survey.
  • For those who do not receive an appointment invite, we will send updates each Monday and continue the process until everyone who wants a vaccine gets one.

*Your appointment invitation might come from MU Health Care, Columbia/Boone County Public Health and Human Services or Boone Health.

Things to keep in mind

  • If you previously filled out the survey on the Columbia/Boone County Public Health and Human Services website, you do not need to fill out the survey again.
  • Even if you fall into an eligible tier, you may not be notified with an appointment spot right away because there is far more demand than supply.
  • Once you're on the survey, we will send out a weekly email to keep you updated on vaccination opportunities.
  • Filling out this survey does not guarantee how or when you will get a vaccine; it just allows us a way to contact you when doses are available.
  • This survey is open to anyone, even if you're not currently eligible to be vaccinated.

More information


  • Please note that we are following state guidelines on prioritizing populations to be vaccinated.
  • The state of Missouri has approved vaccinating people in Phase 1A and Tier 1 and Tier 2 of Phase 1B. Learn more about the vaccine distribution phases.
  • If you've already received the vaccine and want to be removed from our survey, please complete this form.
  • If you have questions or need help, please call 573-771-CARE (2273).
Are you a Missouri resident?
The state of Missouri’s plan prioritizes vaccinating Missouri residents, and we are unable to vaccinate residents of other states.

Thank you for your commitment to stopping the spread of COVID-19!

While you’re waiting your turn for the vaccine, please continue to help us stop the spread by wearing a mask, distancing from others, limiting your contacts and sanitize often and stay home when sick. Go to work, then go home. Go to school, then go home. Run necessary errands, then go home. Be safe.

Vaccines have shown a high level of effectiveness in preventing the illness during their clinical trials, but it’s important to remember that they are just one part of the combination of tools available to help stop the pandemic. Even after being vaccinated, you should continue to follow all the guidelines listed above.

By clicking submit, you agree to receive follow-up information from MU Health Care via unsecured email. We do not share your information with anyone else, and you may opt out at any time. Privacy policy.

Note: If the form refreshes and you don't see a 'thank you' message, make sure you have selected a choice for each question with a red asterisk.