Residential/LTCF Vaccine Clinic Request

Thank you for contacting the Southern Nevada Health District to request our participation at your facility. Please complete the form below, your request will be forwarded to one of our team members and they will contact you within 3 business days to coordinate.

Please tell us about your event

Name of Organization(Required)

Contact name(Required)

Contact email(Required)

Contact phone(Required)

Event address(Required)

Facility Street Address City State ZIP Code

Updated on: February 12, 2024