COVID-19 Vaccine Clinic Requests

COVID-19 Vaccine Clinic Request Form

Are you interested in providing COVID-19 vaccines for your employees?

WakeMed Corporate and Community Health provides onsite vaccine clinics directly at the workplace. We offer the Pfizer, Moderna, and the J&J vaccine. The Pfizer Comirnaty and Moderna Spikevax COVID-19 vaccines have been fully approved by the U.S. Food and Drug Administration (“FDA”) for ages 16 and older and 18 and older, respectively. Additionally, the FDA has approved administration of the Janssen vaccine, administration of the Pfizer and Moderna vaccine to certain pediatric age groups, and additional booster doses of the vaccines for some individuals under an Emergency Use Authorization (“EUA”).

See details about each vaccine.

If you’re interested in hosting a COVID-19 vaccine clinic at your worksite, please complete the fields below and someone will be in contact with you shortly. If you have any questions, please contact krobins@wakemed.org.

Company Name

Point of Contact Name

Email Address

Phone Number

Event Address

Event Room

Preferred Date 1

Preferred Date 2

Preferred Date 3

Preferred Time of Event

# of Expected Participants

Which type of vaccine would you prefer?

Johnson & Johnson

Moderna

Pfizer

Moderna and Pfizer are a 2-dose series, which is given 28 days apart. Johnson & Johnson is a 1-dose vaccination. Vaccine type is dependent on allocation, which is determined on a weekly basi

Care & Services

Patients & Visitors

WakeMed Physician Practices

COVID-19 Vaccine Clinic Requests

COVID-19 Vaccine Clinic Request Form