DOH Request Vaccine Survey

DOH Request Vaccine Survey

Below is the link for the DOH survey for vaccine needs.  If you are waiting for vaccine for your new residents or staff, please contact your long-term care pharmacy, alert your LHJ to vaccine needs and then complete the DOH survey.  Please let your LHJ know if you have requested DOH assistance and keep documentation of all efforts.

Long Term Care Facilities COVID-19 Vaccine Request Survey 




Laura Hofmann, MSN, RN – Director of Clinical and Nursing Facility Regulatory Services
c: 425-231-4804

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April 28, 2021