On-site COVID-19 Clinic Request for Kent County Businesses and Organizations
Kent County Health Department is gauging the interest of our business, faith, and community-based organizations in having COVID-19 vaccine clinics offered on-site.

There will need to be a minimum number of vaccine recipients registered for us to come on-site. Groups in increments of five or ten are required depending upon the preferred product (Johnson & Johnson or Moderna). At this time we are not doing walk-up clinics.

Please only submit one form per organization. Our team will review all submissions and contact you with more information. Thank you for your interest in offering the vaccine at your organization!
Email *
Please select one. I am completing this form on behalf of a: *
Next
Never submit passwords through Google Forms.
This form was created inside of State of Maryland. Report Abuse