COVID-19 Vaccination Opportunity

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In a continued effort to provide health and safety options for both students and staff, Itasca ISD is surveying the continued interest of vaccine availability. Your feedback will help provide information regarding another potential on-site vaccine opportunity in the upcoming weeks.

I am...

student over the age of 12

student over the age of 18

faculty/staff member

parent/guardian

community member with no students in the school

None of the above

I do not wish to answer (Thank you. You do not need to continue with the survey)

Clear selection

Are you interested in reciveing the vaccine?

Yes

No (Thank you. You do not need to continue with the survey)

I am already vaccinated (Thank you. You do not need to continue with the survey)

I do not wish to answer (Thank you. You do not need to continue with the survey)

Clear selection

I am interested in the vaccine (This will help us determine what type of vaccine needs to be on-site. In most cases Moderna vs. Pfizer, both being two does vaccines)

student over the age of 12

student over the age of 18

faculty/staff member

parent/guardian

community member with no students in the school

Clear selection

What time of day would be most benefical?

During the work/school day

After the work/school day

An opportunity for both during and after the work/school day

On a weekend (Saturday)

It does not matter

Clear selection

Questions/Comments:

Submit

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