County of San Diego COVID-19 Response - Vaccination Site/Pod and Clinical Staffing

Thank you for your interest in the County of San Diego's COVID-19 response. If you are able to provide a vaccination site/pod or clinical staff to the County, please provide the information requested below. If you are interested in providing other vaccine services or supplies, please use the link to the COVID-19 services and supplies form below. Should the County have a need for or questions regarding your services, a representative from the County will contact you.

Please note that all purchases made by the County will be in compliance with any applicable federal, State and local laws and regulations, including California Penal Code Title 10 (link).

If you are interested in providing other COVID-19 supplies or services (including testing and vaccine-related items), or hotel/motel rooms, please see the links below for the correct survey/form:

PPE/Supplies, Equipment & Services (including testing and vaccine-related items): https://www.surveymonkey.com/r/BYQWHCG

Hotel/Motel Rooms: https://www.surveymonkey.com/r/PLK6DLH

Question Title

* 1. Contact Information

Name *

Company *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

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* 2. Website Address

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* 3. Type of vaccine-related services or supplies. If you are offering more than one category, please submit a separate form for each.

Full Service Vaccination Site/Pod

Clinical Staff Only