Los Angeles County Department of Public Health COVID-19 Vaccine Related Donations
If you have goods or services to donate to our COVID-19 vaccination efforts, please complete the form below. A representative from the Department of Public Health will contact you to discuss your donation offer. Serious inquiries only please.
Name *
Company
Email Address *
Phone Number *
Website URL
Location (Address, City, State, ZIP)
Type of Donation
Please describe the donation including amount of capacity.
Can you deliver the donation, if applicable?
Clear selection
Is there any cost for or associated with the donation?
Clear selection
Please provide any details related to the cost of the donation, if applicable.
Is the donation worth more than $10,000?
Clear selection
What is the earliest date and time you could provide the donation?
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Please briefly describe your company/organization.
Do you/your organization have experience providing vaccinations or disaster relief?
Clear selection
Do you currently do business with Los Angeles County?
Clear selection
If yes, please describe.
Please provide your Los Angeles County Vendor Number, if applicable.
Please provide any additional information regarding the donation that was not included above.
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