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Phase 1A (All Priorities) COVID-19 Vaccination Survey

Phase 1A (All Priorities) COVID-19 Vaccination Survey

Central Michigan District Health Department is looking to collect some preliminary information at this time from businesses and organizations in Phase 1A and also individuals who may be self-employed or working independently in occupations under Phase 1A.  
 
We ask that you answer the questions in this survey as best as you can.  An email address is required. Thank you for your time.  
This question requires a valid date format of MM/DD/YYYY.
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2. Please select the category that best describes your facility/organization or job/occupation. *This question is required.
  • * This question is required.
4. What county is your facility/organization in OR, if you are answering as a self-employed worker, which county would you like to be vaccinated in? *This question is required.