Help with a State Agency

Thank you for contacting our office for assistance with a state agency.

If you have questions on how to schedule a COVID19 vaccine, or need additional information on the phase that you or a loved one fall into for the vaccination schedule, please do not submit your information via this form.

Please visit the state’s vaccine website at https://www.vaccines.nh.gov to schedule your vaccine starting on Friday January 22, 2021.

For any additional questions or information on the COVID19 vaccine, please contact the 2-1-1 resource center, by dialing 2-1-1 from your New Hampshire telephone exchange.

For assistance with any other New Hampshire State Agency, please continue by submitting your information on the form below.

Thank you

All Required Fields * must be completed

First Name

Last Name

Address

City / State / Zip

County

Email Address

Phone Number/Extension

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organizerPhoneExt

Alternate Phone Number/Extension

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organizerAltPhoneExt

Agency Involved

Nature of Problem

(*Please provide a detailed description of the problem you are experiencing and what assistance you have already sought out prior to contacting the Governor's office.)

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