Essential Worker Preliminary Survey
LMAS District Health Department is collecting preliminary information on essential workers. Stay tuned for when your time comes to schedule your vaccine.
* Required
Today's Date
*
MM
/
DD
/
YYYY
Type of facility/organization:
*
Food and agriculture
Energy
Water and wastewater treatment
Transportation and logistics
Communications and information technology
Other community or government based operations and essential functions
Critical manufacturing
Hazardous materials
Financial services
Commercial facilities
Housing and real estate related services
laboratory services (non-hospital)
Mortuary services
Other:
Name of employer:
*
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
E-mail address
Your answer
County you plan to be vaccinated in:
*
Luce
Mackinac
Alger
Schoolcraft
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