Clinics, pharmacies, and hospitals interested in administering COVID-19 vaccine must enroll in the federal COVID-19 Vaccination Program. The Washington State Department of Health (DOH) is coordinating this enrollment process for providers in Washington state.
Preparing to Enroll
- Preparing to Enroll in the COVID-19 Vaccination Program (PDF)
- Preparing to Enroll in the COVID-19 Vaccination Program (PDF) (slide deck)
- Provider Preparation Checklist (PDF)
- Centers for Disease Control and Prevention (CDC) COVID-19 vaccination program provider requirements and support
If you are interested in enrolling in the COVID-19 Vaccination Program, please complete the provider inquiry form. This form is only for clinics, pharmacies, or hospitals interested in administering COVID-19 vaccines. If you are looking for information on where you can get a vaccine, please visit www.CovidVaccineWA.org.
We will follow-up with your organization as soon as possible. You can use the COVID-19 Provider Enrollment Guide (PDF) to help you through the enrollment process.
Please contact us at firstname.lastname@example.org if you have questions about the enrollment process or need technical assistance.
If you no longer want to participate in the COVID-19 Vaccination Program, you can disenroll by completing the Provider Disenrollment Form (PDF) and emailing it to Covid.Vaccine@doh.wa.gov. Please note: Once you are disenrolled from the program, you will need to complete the enrollment process again if you want to offer COVID-19 vaccines in the future.
Frequently Asked Questions
- Who can enroll in the COVID-19 Vaccination Program?
Any clinic, pharmacy, or hospital interested in administering COVID-19 vaccines can enroll in the program. However, your facility must have a provider who is licensed to administer the vaccine. See the list of authorized providers.
You may start the enrollment process by completing the provider inquiry form (PDF). You may also use the Preparing to Enroll (PDF) and Provider Enrollment (PDF) guides to make sure you have access to all the necessary information before enrolling.
- Does each location in my organization need to enroll in the COVID-19 Vaccination Program?
Yes, you will need to enroll each location that will receive or administer vaccine. However, you will only need to sign the provider agreement once. See the enrollment guide for instructions on how to complete the form for multiple locations.
- Do we need to enroll temporary administration sites, like pop-up clinics?
No, but you should enroll the facility that oversees or is responsible for the temporary clinic site. You should also review the off-site clinic guidelines and checklist (PDF) and submit an off-site vaccination clinic request to email@example.com at least 24 hours in advance of the clinic.
- Who can fill out the enrollment survey?
Anyone in your organization can complete the enrollment survey if they have access to all the necessary information. However, the Chief Medical Officer and Chief Executive Officer will need to sign the agreement.
- When is the enrollment form due?
There is no due date for enrollment, but we encourage you to complete it as soon as possible to be ready to receive vaccine.
- Do we need to list every provider at our organization?
No, you only need to include providers with prescribing authority who will delegate or administer vaccine.
- What storage documentation are we required to submit?
We need the following documentation to confirm your facility is ready for vaccine:
- Pictures of the inside and outside of your storage unit(s)
- At least three consecutive days of temperature log data
- Unit model number(s)
- Certificate of calibration
If you are unable or unsure how to collect these, please contact us at firstname.lastname@example.org.
- We aren't ready to administer COVID-19 vaccine yet. Should we still enroll in the program?
Yes, the enrollment process can take a little time, so we suggest completing it as early as possible to prevent delays. You can opt out of receiving vaccine until you're ready.
If you're waiting for additional equipment to arrive, you may still complete the enrollment process now and include a note about the pending equipment. Once your equipment arrives, please gather all the necessary information and email it to email@example.com. We will update your enrollment forms.
- How can I edit my enrollment after submitting it?
The enrollment forms lock once you complete and submit all forms. If you would like to make a change, please email firstname.lastname@example.org with your organization name and the correction.