COVID-19 Vaccine Form Available for Essential Worker Groups

A vaccination request form is now available on the Calhoun County website for essential front-line organizations that meet Phase 1B criteria. Calhoun County Public Health Department (CCPHD) has released an online form strictly for agencies or organizations that meet the qualifications of Phase 1B. Phase 1B is determined by the Michigan Department of Health and Human Services, and industries included are listed in the graphic.

The CCPHD ask for a point of contact of the organization to fill out the form and submit on behalf of the organization they represent. This form is not intended on individual submissions of front-line workers. Once the Public Health Department receives the request and agrees that your organization meets the criteria, we will contact you to schedule a clinic with your agency.

There is limited vaccine in Michigan, so appointments may not yet be available. Please be patient! Appointments will be added as more vaccine becomes available. Eligible front-line essential workers will be notified by their employers about vaccine clinic dates and locations.

A completed request does not mean an appointment is available yet. You will receive a call when an appointment is available to your agency or organization. To access the Phase 1B Essential Frontline Workers Vaccine Request Form please click here.

CCHD