COVID-19 Vaccination at NWICDC
Please complete this form if you are interested in receiving the COVID-19 vaccine during a vaccination event at the Northwest Indian Community Development Center when it becomes available for your group.
The first event for adults age 65+ will take place on a Friday, we will call you the Monday before to schedule an appointment for you to come in.
*Note: we won't know the exact date until a week in advance when the Minnesota Department of Health moves to the next vaccination phase.
If you have any questions on how to get tested or about the vaccine, please call our COVID Hotline at (218) 215-2832.
Your first and last name
Are you age 65+? If not, we will contact you when we host another event for the general population.
What is your phone number?
Do you need assistance with transportation? If so, please provide your address below.
Do you have a Personal Care Assistant (PCA) that would be interested in receiving the vaccination at the same time as you? If so, please provide their name.
Do you have any questions or concerns regarding the vaccine that we can help clarify?
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This form was created inside of Northwest Community Development Center.