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Vaccination Plan Survey

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Vaccination Plan Survey

With the Vaccination Plan Survey

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Please answer the following questions about your vaccination plan.

Email*

What is your full name?*

What is your date of birth?*

What is your occupation?*

Have you received a COVID-19 vaccine?*

Yes

When did you receive your fi...

Select date

Description:Take the Vaccination Plan Survey to help us understand your vaccination needs and preferences. Your responses will help us develop a plan to ensure that everyone gets vaccinated in a safe and efficient manner. The survey is quick and easy to complete, and your input is greatly appreciated.

Are you wondering when and where you can get vaccinated? Do you have concerns about the safety and efficacy of the vaccine? Take the Vaccination Plan Survey to share your thoughts and help us develop a plan to ensure that everyone gets vaccinated in a safe and efficient manner. Your responses will help us understand your vaccination needs and preferences, including your preferred location and time for vaccination, your concerns about the vaccine, and your willingness to get vaccinated. By completing the survey, you will be helping us develop a plan that meets the needs of our community and ensures that everyone has access to the vaccine. Thank you for your participation in this important effort.

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Patient ID*

Date of Birth*

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Gender*

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