Vaccine Survey - ASW Community
Between now and December, we have the opportunity to provide additional vaccines to our community here at ASW. As with many vaccines, we need to determine interest before providers are willing to schedule staff and resources to serve our school community. Low interest may mean we won't be able to provide these vaccines and you'll have to seek them through other sources.

There are two sections below - one for COVID vaccine and one for Flu vaccine. You will first answer whether you are interested in either vaccine and then answer additional questions for each.

This survey is setup to be filled out one time per family. Only one family member should fill it out for all members. Invitation to register for the vaccination events will be sent to the email address provided below.
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Email *
Name of the person filling out this form. *
I would like one or more members of my family to get a flu vaccine at school *
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