Get in touch today to get
your group vaccinated.

Just fill out this short form on the right to get started. We will be in touch shortly.

We need to know a few details about your organization to match you with providers or to route your group to a vaccination site.

Questions? Call the OC COVID-19 Hotline at (714) 834-2000.

Organization Information

Contact Information

Payee Information (Optional)

Clinic Information

By submitting this form you are authorizing Composite Apps, Inc. to share the information you provided with our network of healthcare providers that are administering the COVID-19 vaccination. This information will not be shared with anyone else, and you will receive a follow up email to confirm your registration to be vaccinated.