What is this? An intake form to understand what support you would like from the State of California to organize a mobile or pop-up COVID-19 vaccination clinic.

Who can fill it out? Any organization interested in organizing a mobile or pop-up clinic, particularly local health departments, schools, employers, community-based organizations, and faith-based organizations.

**If you are in Los Angeles county (excluding Pasadena and Long Beach), there is a different request process for mobile vaccination teams. Please use this link.  

What type of resources are available? Potential resources include matchmaking with providers in your community, specific resources to help fill gaps at your sites (e.g., signage, tents, generators, restrooms, heaters), and full turnkey sites.

What should you expect? Submitting a request does not guarantee resources. We will review and prioritize your request on a flow basis. A representative will reach out to you within 3 business days to follow up.

Note for K-12/Childcare and 5 & under - Please ensure a minimum of 50 vaccine recipients per day per event. If you feel there is limited access to vaccines in your area, please let us know, and we will consider your request.
For Local Health Departments: If you would like to request specific vaccination supplies through MHOAC/MHCC (e.g., staffing, PPE, fridges), please reach out to your MHOAC directly.
If you have any questions, please reach out to MobileVaccineSites@cdph.ca.gov
17% of survey complete.