![COVID-19 Vaccine Form Available for Essential Worker Organizations](http://townsquare.media/site/656/files/2021/01/GettyImages-1230700338.jpg?w=980&q=75)
COVID-19 Vaccine Form Available for Essential Worker Organizations
A vaccination request form is now available on the Calhoun County website for essential front-line organizations that meet Phase 1B criteria. Calhoun County Public Health Department (CCPHD) has released an online form strictly for agencies or organizations that meet the qualifications of Phase 1B. Phase 1B is determined by the Michigan Department of Health and Human Services, and industries included are listed in the graphic.
The CCPHD ask for a point of contact of the organization to fill out the form and submit on behalf of the organization they represent. This form is not intended on individual submissions of front-line workers. Once the Public Health Department receives the request and agrees that your organization meets the criteria, we will contact you to schedule a clinic with your agency.
There is limited vaccine in Michigan, so appointments may not yet be available. Please be patient! Appointments will be added as more vaccine becomes available. Eligible front-line essential workers will be notified by their employers about vaccine clinic dates and locations.
A completed request does not mean an appointment is available yet. You will receive a call when an appointment is available to your agency or organization. To access the Phase 1B Essential Frontline Workers Vaccine Request Form please click here.
![WKMI logo](https://townsquare.media/wp-content/uploads/2019/05/WKMIAM.png?w=100)
LOOK: 20 tips to help your houseplants survive the winter
More From WKMI
![Funding For Covid-19 Testing, Treatment and Vaccine Ending](http://townsquare.media/site/656/files/2022/03/attachment-sigmund-By-tZImt0Ms-unsplash.jpg?w=980&q=75)
![Where Are Michigan Schools Spending Their Covid Slush Fund Tax Dollars](http://townsquare.media/site/656/files/2022/01/attachment-raining-cash.jpg?w=980&q=75)
![Students Will Start Spring Semester Remotely at MSU](http://townsquare.media/site/87/files/2020/12/RS36673_CJF_0566-scr.jpg?w=980&q=75)
![Michigan Woman Tests Positive for COVID-19 on Flight to Iceland, Isolates in Bathroom 5 Hours [VIDEO]](http://townsquare.media/site/43/files/2021/12/attachment-Marisa-Fotieo-TikTok-2.jpg?w=980&q=75)
![Michigan Covid Numbers: A Tale Of Whitmer/Trump And Whitmer/Biden Numbers](http://townsquare.media/site/656/files/2021/12/attachment-Whitmer-Biden-Scott-Olson-Getty-Images.jpg?w=980&q=75)
![Married Grand Rapids Couple Die One Minute Apart From Covid While Holding Hands](http://townsquare.media/site/46/files/2021/09/attachment-couple4.jpeg?w=980&q=75)
![Lakeview High School Shuts Down In-Person Learning Even Though Their Covid-19 Numbers Declined](http://townsquare.media/site/656/files/2020/08/Lakeview-High-School-Google-street-view.jpg?w=980&q=75)
![MI Poison Control Center Warns Against Taking Animal Dewormer for COVID](http://townsquare.media/site/84/files/2021/09/attachment-mikael-kristenson-EXuKQaf3Ei8-unsplash-1.jpg?w=980&q=75)
![Governor Whitmer Is Not Being Totally Upfront With Our Covid Numbers](http://townsquare.media/site/656/files/2021/08/attachment-261C3F70-BFAD-4CFC-9A7A-BD69E9B18227.jpeg?w=980&q=75)