All medical volunteers operating at one or more Equivax-operated COVID-19 clinics must complete this registration form to receive their permanent Vaccinator ID Number. This form only needs to be completed ONCE per medical volunteer, and your number is permanently assigned to you.

If you have forgotten your Vaccinator ID Number, click here to retrieve it.

Even if you volunteered at an Equivax clinic before November 7, 2021, you must still complete this form to receive your unique Vaccinator ID Number to ensure compliance with California Dept. of Public Health regulations.