COVID-19 Vaccine Provider Enrollment

Healthcare Providers can find information and forms here to assist them in becoming a COVID-19 Vaccine Provider.

COVID-19 Vaccine Provider Requirements

• COVID-19 Provider Enrollment Checklist (PDF)
• COVID-19 Vaccine Provider FAQ's (PDF)

COVID-19 Vaccine Provider Forms

• CDC COVID-19 Vaccination Program Provider Agreement (PDF)

COVID-19 Vaccine Provider Educational Training

• COVID-19 Vaccine Provider Education Training (PDF)

 

Please send all provider enrollment forms to: C19PA.MECDC@Maine.gov

Please send all other COVID-19 vaccine planning questions to: C19Vaccine.MECDC@Maine.gov