COVID-19 Vaccination Information Request Form

In light of the Covid-19 pandemic, City Hall is open by appointment only from Monday to Thursday from 9:00 a.m. to 4:00 p.m. Thank you for your patience, support and understanding during these challenging times as we look to minimize the risks of COVID-19.

Submitted by warboleda on January 30, 2021 - 12:08pm

First Name/Primer Nombre/Primeiro Nome/Prumeru Nomi *

Last Name/ Apellido/Último Nome/ Apilidu *

Date of Birth/Fecha de nacimiento/Data de nascimento/ Data de nascimentu *

Month

Day

Year

Age/Años/Idade/ Idadi *

Street Address/Direccion de casa/Direção/Inderesu *

Street Name and Number

City/Ciudad/Cidade/Sidadi *

Attention: This form is only for residents of Pawtucket. Individuals who do not live in Pawtucket will be removed from the list.

Zip Code/Código Postal/ Kodigu Postal *

Phone Number/Número de teléfono/Número de telefone/ Numeru di telefoni *

Please enter the area code and do not include dashes (E.g. 4015555555)

E-mail/Correo electrónico/Correio eletrônico/ Kurreiu Iletroniku *

If you do not have an email, please type None@none.com

Are you able to self-register online if given a link? / Puede registrarse por internet si recibes un link?/ Você consegue se autorregistrar online se receber um link? / Bu ta konsigi regista online si bu resebi un link?

Do you have access to transportation? / Tiene acceso a transporte? / Você tem acesso a transporte? / Bu ten assesu a transporti?

Do you have an underlying health condition or are immunocompromised? / 2.) Tiene alguna condición médica o eres inmunocomprometido? / Você tem uma condição de saúde subjacente ou é imunocomprometido? / Bu ten algún kondison di saudí di basi ou é imunokomprometidu?

Mayor Thanks Winners of the Honoring Black History Month Event

February 25, 2021
Press Release

https://youtu.be/nnsGuHyUMsUClick the picture above to view the winners discuss thier pieces!Thank you so much to all of the amazing students who submitted pieces for the Honoring Black History Month... Read More >

City Speak

"The birthplace of the American Industrial Revolution, Pawtucket is poised to undergo a 21st century evolution into Rhode Island's premier arts and cultural destination, an ideal community to live, work, play, start a business and raise a family."

- Mayor Donald R. Grebien

New Event

Voter-Approved Citywide Paving Continues

May 29, 2020
Event

PAWTUCKET – Mayor Donald R. Grebien, the Pawtucket City Council, and the Department of Public works have announced the citywide repaving of streets and roads.“Quality of life for our residents is of... Read More >

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