COVID-19 Vaccine Information Request

Thank you for reaching out to us about the COVID-19 vaccine. To best assist you, please fill in all fields on the below form with information for the patient in question, select the nature of your inquiry, and include any additional comments that will help our customer service agents respond.

Due to the high volume of inquiries, please give us one week to respond to your message. To help us process this request, we will need your Medical Record Number (MRN). From myUCLAhealth, you can find your MRN by hovering over the "Health" icon and clicking on "My Profile." It will appear under Patient Information as well as Patient ID.

As you wait for a response, please view the following to find up-to-date vaccine information:

Thank you for choosing UCLA Health to be your partner in health care.