Please visit this website to verify your eligibility to vaccinate: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/Authorized-Licensees.aspx#

Thank you for your interest in assisting with the COVID-19 vaccination clinics in the Yuba and Sutter area. Please take the time to answer this short survey to be added to our list of potential vaccination volunteers. Someone from Public Health will reach out with volunteer opportunities as they arise.

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* 1. Full Name

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* 2. Date of Birth

Date

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* 3. Address

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* 4. Phone Number

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* 5. Email

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* 6. License Number

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* 7. License Board

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* 8. Days Available to Volunteer

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