Champions for Vaccine Equity Request Form - Routine Vaccine Educational Events
Champions for Vaccine Equity is a program administered by the Immunization Branch at the Colorado Department of Public Health and Environment (CDPHE). The purpose of this program is to foster relationships and share information with communities about vaccine effectiveness, safety, and access.

CDPHE coordinates vaccine education workshops, provides training and attends health fairs across Colorado. The program is composed of Champions, primarily health care professionals, who provide information to various community-based organizations, schools, faith-based organizations, and businesses. The goal of these events are to help communities gain accurate information and educational resources to empower people to make decisions that are best for themselves and their loved ones. These events are free and open to the public. We encourage historically underrepresented and rural communities to take advantage of this program.

A Champion workshop is usually an hour long. It includes a 30 minute presentation followed by a Q&A session and discussion between the Champion(s) and audience. While the format of the event typically consists of a presentation followed by Q&A, we can also customize Champion workshops. A workshop, training or attendance at a health fair usually takes 2-4 weeks to plan.

If you're interested in having a Champion speak with your community virtually or in-person, please fill out the form and someone from our team will follow up with you within 2-3 days.
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Email *
Organization Name *
Contact Name *
How did you hear about the Champions for Vaccine Equity Program? *
What type of event are you interested in?
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First Preference: Event date, time, location and in person or virtual. (Please note it takes at least two weeks to plan an event.) *
Second Preference: Event date, time, location and in person or virtual. 
Workshop Language(s) - Please provide the language needs of your community
[If applicable] Are you able to provide interpretation services?
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Our routine vaccine educational workshop covers general information around routine vaccines but can be tailored to specific vaccines as well. We are constantly modifying the content to ensure it's applicable to the current vaccine landscape. With that being said, are there specific "areas of interests" or vaccines that your community would like additional emphasis on?
Estimated Number of Attendees
Please provide a brief overview of expected attendees (e.g. parents of youths, youth groups, community health workers, etc.) *
Please provide any additional information that would be helpful for planning purposes.
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