Thank you for contacting the Southern Nevada Health District to request a COVID-19 vaccination event. Please complete the form below with as much information as possible and submit TWO WEEKS in advance of your desired event date(s). A member of our team will be in touch within 3 business days to discuss additional information. Please note, we strive to fulfill all requests but prioritize COVID-19 vaccination clinics based on community needs, resources, and immunization staff availability. Completion of this form does not guarantee an event will occur. Thank you for your understanding.

Event Date*
Event Start Time*
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Event End Time*
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Event Address*
Type of Facility*
Preferred Clinic Type*