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COVID-19 Vaccine Outreach Information
This Vaccine Outreach is a partnership of Little Washington Growing Group (LWGG), Little Washington Christian Academy (LWCA), Rebuilding Broken Places (RBP), and Community Technical Assistance Inc. (CTA)
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Email
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Your email
What type of services do you need?
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COVID-19 Vaccination
COVID-19 Testing
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What is your full name (First and Last name)?
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Your answer
What is your address (Street name, City, State, Zipcode)
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Your answer
What is your phone number?
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Your answer
Have you scheduled you appointment?
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Yes
No
What time is your appointment?
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Your answer
What is the location of vaccine or test?
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Your answer
Are any special accommodations for transportation that you need?
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Yes
No
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