If you are currently eligible to receive the vaccine (Phase 1A or Phase 1B, tier 1) and need to get your first dose, please call our automated vaccine line at 833-770-0530 to add yourself to the wait list for a first-dose appointment and request updates. More information
Our Financial Assistance Application and Proof of Income instruction sheet are available to download in several languages.
Financial Assistance Application:
English
Arabic
Burmese
Chinese-Simplified
Chinese-Traditional
French
German
Italian
Khmer
Korean
Lao
Marshallese
Punjabi
Russian
Somali
Spanish
Tagalog
Ukrainian
Vietnamese
Proof of Income Instruction Sheet:
English
Arabic
Burmese
Chinese-Simplified
Chinese-Traditional
French
German
Italian
Khmer
Korean
Lao
Marshallese
Punjabi
Russian
Somali
Spanish
Tagalog
Ukrainian
Vietnamese
*Please submit completed financial assistance application forms using ONE of the following methods: