COVID-19 Vaccine Interest Form – Group 2
The following people are considered eligible for vaccination in Phase 2
Group 2: General Public:
- Anyone age 16+
Please complete this form if you would like to be added to a list to receive information about COVID 19 vaccination opportunities and/or appointments as they become available.
Your information will not be shared outside of Rio Grande Hospital and Clinics. Filling out this form will inform us of the number of people interested in receiving a vaccine in each phase. It does not guarantee a vaccine in any time frame. The pace at which we are able to provide vaccinations is dependent upon vaccine availability and evolving State and Federal guidance. After you register here, YOU WILL BE CONTACTED BY EMAIL, TEXT OR PHONE to setup an appointment as the vaccine becomes available. Note* Any email or text received for an appointment for a vaccine is meant solely for the person to whom it was sent.
Please only register using this form once per person. All fields are required.
Thank you for working with us to help keep our community safe and healthy.
Mission: With a smile and a helping hand, we provide quality care and service to our communities.
Vision: We will distinguish ourselves as the trusted healthcare destination.
We will provide compassionate healthcare and advocate wellness through innovative access, preventive medicine,
and collaborative partnerships within our diverse community.
OUR LOCATIONS
Rio Grande Hospital
310 County Road 14
Del Norte, CO 81132
Tel: 719-657-2510
Open: 24/7
Creede Family Practice
802 Rio Grande
Creede, CO 81130
Tel: 719-658-0929
Rio Grande
Hospital Clinic
310C County Road 14
Del Norte, CO 81132
Tel: 719-657-2418
Monte Vista Medical Clinic & Pharmacy
1033 2nd Avenue
Monte Vista, CO 81144
Tel: 719-852-8827
Pharmacy Tel: 719-628-0533
Rio Grande Hospital Clinic at South Fork
52 Jackson Street
South Fork, CO 81154
Tel: 719-873-5494