For employers with frontline personnel
Dakota County Public Health is gathering information about clinics and facilities that meet the qualifications for the initial phase of the vaccine program. The purpose of the form below is to assist Public Health in identifying employers who need assistance in getting access to the COVID-19 vaccine. Completing this form does not guarantee access to the COVID-19 vaccine.
Minnesota currently has a very limited supply of COVID-19 vaccine. See if your clinic or facility would qualify as a priority group on the
Minnesota Department of Health Phase 1 Vaccination Guide.
Most community-based health care providers will not have access to the COVID-19 vaccine during Phase 1a of vaccine distribution. The COVID-19 vaccine will be available to more settings during Phase 2. We do not know when Phase 2 will begin. Thank you for your patience during this time.
Carefully note the following:
- The form below is intended for employers with essential personnel within a closed setting, such as a group home or assisted living facility.
- The form is not intended for non-essential workers.
- The form is not intended for those affiliated with a health care system. If you are affiliated with a health care system, contact your system about access to the COVID-19 vaccine.
​Complete a COVID-19 Clinic and Facility Vaccination Form