Vaccine Provider Portal
COVID-19 Vaccine Provider Portal
In order to provide COVID-19 vaccines, you must have a number agreements in place with NMDOH and the CDC. NMDOH has provided this portal to digitally complete, sign, and submit the required documentation.
Here is a quick overview of the process:
STEP 1: Complete the required agreements.
In order to provide the COVID-19 vaccines your organization must complete the following agreements:
- CDC COVID-19 Vaccination Program Provider Agreement
- CDC Supplemental COVID-19 Vaccine Redistribution Agreement
Provider organizations must complete the entire COVID-19 Vaccine Provider Agreement Packet whereas individual locations within the provider organization must each complete only Section B of the agreement form.
(i.e. Presbyterian Health System must complete a provider organization but Presbyterian Socorro Medical Group, Presbyterian Deming Health Center, etc. must each complete only Section B)
STEP 2: Review & digitally sign the agreements.
The agreements will have a number of required signatures including your Medical Director, CMO, or Equivalant and the CEO, Chief Fiduciary Officer, or Equivalant. Please identify these individuals as they will need to sign the required documentation.
STEP 3: Submit agreements to NMDOH for approval.
Once the documents have been completed, and signed you will need to submit them to NMDOH for approval through this system. Once NMDOH, reviews and approves the agreements you will be notified that your oranization has completed the COVID-19 Vaccine Provider On-Boarding process.
Request Access to the COVID-19 Vaccine Provider Portal
This portal is intended for providers that are planning on administering the COVID-19 vaccine(s). These providers must have agreements in place with the CDC and the New Mexico Department of Health in order to administer COVID-19 vaccine(s). Those agreements can be completed and submitted via the COVID-19 Vaccine Provider Portal. Click Here to request access to the COVID-19 Vaccine Prover Portal in order to fill out the agreements.
To request access, click on the button below and fill out the required information.