Request for help with Vaccination Appointments: via BaseCamp Service Corp.
BaseCamp31 Service Corp volunteers are currently working to help NEW JERSEY residents  age 55 & Up. This volunteer initiative is in place to assist senior citizens with securing  COVID vaccination appointments.

Please note:
If you receive a vaccine appointment you will likely be notified directly from the pharmacy or hospital.
You will also receive confirmation call/text/ or email from BaseCamp volunteers. Please check your email and phone while waiting for an appointment.
If you secure an appointment elsewhere please email us at servicecorps@basecamp31.org to let us know so that we can help the next person.
By submitting your information here, you understand that this is a volunteer effort, and that BaseCamp, nor its volunteers, or partners can provide medical advice and cannot be held liable for any medical appointment or outcomes.  www.BaseCamp31.org
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PLEASE NOTE: BaseCamp volunteers are currently ONLY assisting individuals ages 55 & up and individuals experiencing true barriers to accessing vaccine appointments due to physical, mental, or situational disabilities.  All community members under the age of 55 are asked to check back on our website or Facebook page for updates.  If volunteers are able to accommodate requests for individuals under the age of 55 we will post an update. Thank you for understanding and please note that requests from those under age 55 will not be accommodated at this time.
www.BaseCamp31.org                                      https://www.facebook.com/BaseCamp31N
First Name *
Last Name *
AGE *
Birthday (Note: We are currently ONLY scheduling for patients 55 & up.) Please bring ID to your appointment. *
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Comments, Allergies, Disabilities, Questions (required if under 55)
County you live in
Street Address *
City *
State *
Zip code *
Email (required for confirmation) *
Gender at birth (This question is asked by vaccine sites.)
Clear selection
PHONE #.                                                                                Please note a volunteer may call to confirm your appointment. Please check your voicemail. *
Additional Phone # (if you don't use your cell phone or would like to add a caretaker or family member.)
How far are you willing to travel ? Please specify by time 30 minutes, 1 hr, 2hr etc. *
List dates or times you are NOT available?
~~Please note- once a volunteer  books an appointment for you we will send and email or phone call to confirm.  We ask that you acknowledge that confirmation so we know that you are all set.                                                           ~~~~ If you choose to cancel, change, or re-schedule that appointment, we ask that you do so directly with the pharmacy, hospital, or other vaccine site. *
How did you hear of us? (Please be specific.)
By submitting your request here, you agree and give permission to a BaseCamp volunteer to secure an appointment on your behalf. You understand that volunteers can not guarantee specific locations or vaccines by a particular manufacturer. You understand that volunteers, BaseCamp, nor its affiliates can be held liable for any medical advice, or vaccine related appointments and/or interactions. *
For more information BaseCamp or to share this service with others please visit the Community tab on our website. Or email servicecorps@basecamp31.org
www.BaseCamp31.org
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