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COVID-19 Vaccination Registration and Healthcare Provider Enrollment – Quick Link

Phase 1 A- COVID Vaccine Request

During the first phase, the following groups have been identified are at highest risk for contracting coronavirus and will receive vaccines first.

Paid or unpaid people serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including but not limited to;

  • Staff in clinical settings – nurses, physicians, Licensed EMS, laboratory staff, environmental services, etc.

If you are a Phase 1 A worker AND need to be vaccinated by your local health department please register for your vaccination below.

HEALTHCARE PROVIDERS

If you are a healthcare provider and would like to provide the COVID-19 vaccine for patients/staff, please read and follow the directions below.

COVID-19 Vaccine Healthcare Provider Enrollment Process

1. Complete the COVID-19 vaccine pre-enrollment questionnaire at:  https://www.surveymonkey.com/r/DMBGGJP

2. After receipt of your pre-enrollment questionnaire, the Georgia Immunization Program (GIP) will place providers into tiers that align with the Priority Population Vaccine  Allocation Plan developed using the federal framework as a guide. GIP will send you the CDC Provider Agreement for your facility/entity to complete and submit back to GIP.   This is being done as a phased approach, starting each week with Tier 1a and Tier 1b groups and moving through the enrollees, so the time to receive this form will vary. The enrollment process has moved from a paper-based format to an online format in GRITS,
and more details will be provided.

3. Once GIP receives your completed Provider Agreement, they will send a confirmation email to you. GIP staff will work with providers individually to obtain any missing information, and to verify that all requirements have been met.

4. You will need to complete training for shipping, handling, and storage of COVID-19 vaccine, along with GRITS training and administration processes. Links to online training will be provided after your Provider Agreement is approved.

Providers may check their enrollment status by emailing the Vaccine Enrollment Team: DPH-COVID19Vaccine@dph.ga.gov

This mailbox is monitored during normal business hours Monday through Friday (except when State offices are closed). Additional guidance will be provided in a Provider Newsletter, which will include a more specific timeline for enrollment.