Warren County Public Health says they will work with you as they continue to receive doses from the Ohio Department of Health.
They do not have an ETA on when doses will be available. Only submit this form if you are in the Phase 1A list. All others will not be kept until they match a Phase. You will need to submit a new form at that time.
If you are in Phase 1a and have the ability to come to the Warren County Health District within an hour or so, due to the limited shelf life of the vaccine once opened, they can put your name on a list to call if you can come at that time. This will be 9 or fewer doses that could be available at the end of a vaccination clinic that must be used by the end of the day. They have added a question to their Covid-19 Vaccine Form that will allow you to opt into this option.