Hudson Regional
Health Commission
Carrie Nawrocki, Executive Director / Health Officer
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If you are interested in Hudson Regional Health Commission bringing a vaccination clinic to your organization or business, please fill out the form below and click submit. Someone from our office will contact you once your request has been received. Please note that the information asked below must pertain to the facility where the vaccination will take place. The facility must be located in Hudson County. Thank you.
First Name
Last Name
Organization Name
Address
Address Line 2
City
Bayonne
East Newark
Guttenberg
Harrison
Hoboken
Jersey City
Kearny
North Bergen
Secaucus
Union City
Weehawken
West New York
State
Zip
Email
Phone
Number of people interested in getting vaccinated
Date interested in vaccination
Children
Vaccines for Children (VFC)
Adults
COVID-19 (Moderna and Pfizer)
Flu
Monkey Pox