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Massachusetts Mobile Vaccination Clinic Request Form

PLEASE READ ALL OF THE INFORMATION BELOW BEFORE REQUESTING A CLINIC.

The Commonwealth is pleased to offer Massachusetts organizations the option to easily vaccinate groups against COVID-19. Mobile vaccination services are available for employers, schools, community organizations, priority populations, and other groups. Please visit our webpage for additional information and resources: https://www.mass.gov/info-details/covid-19-mobile-vaccination-program

If you are interested in hosting a mobile vaccination clinic in your community, please fill out the following form. Clinics for children ages 5-11 will be prioritized at this time.

Please submit one (1) form request per location. A representative will contact you to follow-up on scheduling a clinic, if appropriate. 

The contact may take 5-10 business days. Please do not advertise your clinic until you receive confirmation from DPH that your preferred date and time is available.

If you are looking for a first, second or booster dose, over 500 locations are readily available. Please use the VaxFinder tool at vaxfinder.mass.gov to find a location near you.

Please note that filling out this form does not guarantee the availability of a mobile clinic. We will work with you to arrange a clinic that meets your community's needs, as possible.

At this time, clinics are not being held in buses, vans and/or other vehicles.

No ID or insurance will be required for vaccination. Clinics will offer the choice of the Pfizer, Moderna, and/or J&J vaccines. Vaccines will be free to all. Flu vaccines will NOT be offered.

Massachusetts is now vaccinating children under 5 years old against COVID-19. You are now welcome to request a clinic to include this population.

Minors 6 month -17 years may receive vaccination with appropriate consent provided electronically or in writing. Please review the Massachusetts COVID-19 Vaccine Consent Form: https://www.mass.gov/lists/covid-19-vaccination-consent-form-for-individuals-ages-5-17

It is recommended that all November clinics be held indoors, however if an outdoor location is desired, an indoor alternative must be provided and accessible (even if a larger community event is taking place outdoors).

The mobile provider has discretion to determine safety of an outdoor clinic for their team based on weather. If an indoor location is not available, a provider has discretion to cancel an outdoor clinic if they believe weather will make it unsafe for their staff and guests.

December 2022 - March 2023: all clinics must be indoors.
Contact Information: *This question is required.
Type of Organization *This question is required.