Umoja Health - COVID-19 Vaccine Interest Form

Thank-you for your interest in getting a COVID-19 vaccination with Umoja Health. By filling out this form you are expressing interest in being vaccinated at our site in the future. Your responses will be reviewed by Umoja Staff to determine if you are currently eligible for the COVID-19 vaccine. Eligibility is determined by Calfornia state criteria-eligibility criteria is explained here.

Filling out this Interest Form does not guarantee you an appointment with Umoja Health. We will contact you to assess elibility and schedule an appointment if you are eligible.

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