Vaccination Update
WE WILL NOW BE PROVIDING WALK-IN VACCINATIONS, NO APPOINTMENT NECESSARY!

NO NEED TO FILL OUT THIS FORM TO ATTEND ON FRIDAY FROM 11AM - 2PM.

IF YOU HAVE ANY QUESTIONS, EMAIL KEN@RAINBOWCNTR.ORG. THANKS!

You'll have a choice of Phizer (2-dose) or Johnson & Johnson (1-dose).

DATES: Friday May 14 & Friday June 11
TIME: 11:00 AM – 2:00 PM
WHERE: Philip Hall, UW Tacoma Campus, 1918 Commerce Street, Tacoma WA 98402

FREE PARKING: CRAGLE LOT -- S 21st St & Center St.
Sign in to Google to save your progress. Learn more
Full name: *
Name I like to be called:
Phone:
Can we send texts to phone number above?
Email:
Birthdate: (Ages 19 and older; see note above.) *
MM
/
DD
/
YYYY
Preferred appointment time on both days (May 14 and June 11) between 9:40 AM – 2:50 PM: *
Time
:
Please let us know of any language or accessibility needs for your visit.
Any other notes or questions?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Rainbow Center. Report Abuse