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
 
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.
 
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
 
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