Thank you for taking the time to complete this survey. This survey is intended for the following agencies and facilities:
Healthcare providers with less direct contact with COVID-19 patients (e.g., home health, hospice, pharmacy, dental, etc) and EMS
Firefighters, police, COVID-19 response personnel, correctional workers, and funeral services
Frontline essential workers in education, food and agriculture, manufacturing, U.S. postal service, public transit and specialized transportation staff, grocery, public health, and direct care providers for Coloradans experiencing homelessness
Essential officials from executive, legislative and judicial branches of state government
Essential frontline journalists
If your agency/facility does not fall into one of these groups, please do not complete this form.
Completing this form does not guarantee that your agency will receive vaccines but the information you provide will assist Weld County and Larimer County Public Health with our planning efforts for the distribution and administration of COVID-19 vaccines.
Phase 1A is expected to take some time and it may be several more weeks before the state and local health departments are able to move on to Phase 1B or Phase 2. When plans for distributing additional doses of the limited vaccine supply are finalized, we will contact you with more information.