Mobile COVID-19/Flu Vaccination Clinic Request

Please Note:

The Vaccination Clinic is closed until August 2024

Our team is prepared to provide mobile and pop-up clinics to communities within Idaho. We are currently accepting requests and will do our best to provide services off-site. Please note that this is a request form and not a guaranteed service when submitting the form. We will connect with you within a week to discuss this request.

Submit a mobile clinic request

Facility/organization requesting clinic(Required)

Address(Required)

Requested clinic date(Required)

Requested start time

Requested end time

Requested vaccine type

Select one or all that apply (Shift + Click to select multiple)

Approximate number of attendees(Required)

Description of audience (Residents, Faculty, Guests, etc.)

Name of Requestor(Required)

Affiliation/Job title(Required)

Email(Required)

Phone number(Required)

CAPTCHA

Pfizer-BioNTech COVID-19 vaccine
Flu Vaccine
Moderna COVID-19 vaccine
Monkeypox vaccine

Mobile COVID-19/Flu Vaccination Clinic Request

Please Note:

Submit a mobile clinic request

Public Health