This is NOT a required question. The question is to provide health professionals and researchers with data to combat Covid-19.
Please upload a proof of address that matches the name and address of the information you have entered above.
Invalid primary identification upload type.
Please upload a PNG, PDF or JPG.
Invalid alternate form upload type. Please
upload a PNG, PDF or JPG.
Registering on behalf ofEnter the required information for the child or adult on whose behalf you are registering. Do not enter your information below.
Date of Birth
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accurate and up-to-date. MercerCares.org is not responsible for a delay or hardship due
to circumstances that are beyond the control of the Health Department.