RHC Direct COVID-19 Vaccine Allocation Eligibility Form

Question Title

* 1. Are you currently administering COVID-19 vaccines?

Yes

No, but I would if I received the supply

No, and I do not want to or am unable to

Question Title

* 2. Are you currently enrolled to administer COVID-19 vaccines in VTrckS? (It is acceptable if you are not registered)

Yes

No