Volunteer Covid-19 Pre-registration Form

Thank you to Councilmember Charles Allen and the Ward 4 DC Mutual Aide for their assistance in developing a hard copy of the COVID-19 Vaccination Questionnaire for those without access to a phone or internet.

If you need assistance completing this form, either on paper or on-line please contact me at 202.271.3710 or 4B06@anc.dc.gov.