Welcome to the Missouri Department of Health & Senior Services' (MO DHSS) COVID-19 Vaccine Request Form!

Order requests must be received by 5:00 p.m. on Wednesdays. Do not enter order requests into ShowMeVax. Accepted order requests will be entered by MO DHSS staff.

To begin, please answer the following questions regarding your ShowMeVax registration below. Once you are finished, click "Submit" at the bottom of the survey to continue to the next page.

Loading... Loading...
You have selected an option that triggers this survey to end right now. To save your responses and end the survey, click the button below to do so. If you have selected the wrong option by accident and do not wish to leave the survey, you may click the other button below to continue, which will also remove the value of the option you just selected to allow you to enter it again and continue the survey.
The response has now been removed for the last question for which you selected a value. You may now enter a new response for that question and continue the survey.