This form is intended for use by community organizations, those working with underserved populations, and employers in Ada, Boise, Elmore and Valley counties who would benefit from a mobile vaccination clinic opportunity in order to increase the COVID vaccine uptake.

Responses to this form will be used by Central District Health to match community organizations and the populations that they serve with local vaccinating providers who are able to provide mobile services.

We have several regional vaccinating providers who are willing and able to meet community needs, regardless of the clinic size or community location. Some vaccinating providers have launched their own intake forms, and if you know you would like to work with them specifically, you can contact them directly. However, if you do not have a preference for which vaccinating provider you'd like to work with or you would like to explore your options, please complete the following form.