Skip to content Skip to left sidebar Skip to footer

Providers Must Fill Out COVID-19 Vaccine Provider Attestation Form by July 13th

Providers Must Fill Out COVID-19 Vaccine Provider Attestation Form by July 13th

PDPH is requesting that all current COVID-19 Vaccine Providers complete the following attestation form. It will collect information on reporting, AEs, and general COVID-19 storage/handling.

This form needs to be completed prior to Tuesday 7/13/21 at COB. 

Click here to fill out the COVID-19 Vaccine Provider Attestation Form!

If you have any questions, please contact vaccines@phila.gov.

Thank you in advance for your time.