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Sign-up to receive an appointment.

La Clinica offers the vaccine to people living in Contra Costa county. Please provide your information to schedule an appointment. 

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* 1. What is your full name? 

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* 2. Phone Number:

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* 3. Date of Birth:

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* 4. Are you a past or current LC patient (this will not affect your eligibility)?

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* 5. 7. Do you work in any of these fields? (Check all that apply)

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* 6. Are you Age 65+

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