Please fill out this survey to get registered

The Linn County Health Department is following vaccine recommendations from the Centers for Disease Control and Prevention and the Kansas Department of Health and Environment.

By completing this form, your healthcare practice/organization is indicating you would like to be contacted by Linn County Health Department if COVID-19 vaccine becomes available. This does not guarantee your practice/organization will receive the vaccine from Linn County Health Department. If you are able to obtain the vaccine from another provider or need to change the number of doses requested in Linn County, contact us so you can be removed from this list, or so we can make an addendum.

Questions? Please contact Linn County Health Departmentat 913-352-6640 or by email at: preparedness@linncountyks.com

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* 1. Name of Organization

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* 3. Number of Staff/Volunteers to be Vaccinated?

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* 4. Name, Phone Number and Email for contact

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