Pre-registration captures healthcare provider locations that intend to vaccinate and critical information about those locations needed to proceed to enrollment in the program. A site pre-registers by completing the pre-registration survey. All individual clinics will need to complete a pre-registration form. The survey will remain open.
COVID-19 Vaccination Program Provider Agreement and Profile. This document is shared for informational purposes so potential enrollment sites can familiarize themselves with the federal legal requirements of the COVID-19 Vaccination Program.
Follow these steps to complete the enrollment process: