COVID-19 Vaccine Questionnaire
La Joya ISD is requesting input from employees regarding the COVID-19 vaccine in order for our district to continue facilitating vaccines for employees. This voluntary survey will assist La Joya ISD in the decision-making regarding employee and student safety; however, the results of this survey will not be the only information used in the decision-making process. All information gathered in this survey related to employee’s medical information will remain confidential.
Email *
Last Name: *
First Name: *
Employee ID#: *
Campus/Department: *
1. Have you taken the COVID-19 Vaccine? *
2. If you have not yet taken a COVID-19 Vaccine, do you plan to get it?
Clear selection
Next
Never submit passwords through Google Forms.
This form was created inside of La Joya ISD. Report Abuse