Please fill out this form if you are interested in receiving the COVID-19 Vaccine at a clinic at the Red Feather Lakes Community Association Building on April 7, 2021.

By filling this out, you are NOT signing-up or confirmed for an appointment. We will contact you by phone or email if or to sign you up (If eligible) for an appointment for this clinic.  Please be patient as we expect that next step to happen the last week of March.

If you have previously had a severe allergic reaction to food, medicine, or another vaccine, you are not eligible to receive the vaccine at our site, however we encourage you to check with other providers listed here

Question Title

* Personal Information 

Question Title

* What is the best way for us to contact you to invite you to make an appointment?

T