Thank you for your interest in requesting a COVID-19 vaccine clinic for your community.
If possible, please submit requests at least two (2) weeks in advance of your desired clinic date. All requests submitted by 9AM on every Thursday will receive a reply by that Friday. If you have any questions while completing this form please contact Malcolm Furgol at email@example.com or by phone at 240-566-3558. Thank you for your time and assistance.