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Phase 1B Survey for Individuals (75 years of age and older; critical/essential workers)

Phase 1B Survey for Individuals (75 years of age and older; critical/essential workers)

Central Michigan District Health Department is looking to collect some information at this time from individuals who are 75 years of age or older OR individuals who work in a critical/essential workforce.  

More information on Critical/Essential Workers can be found at:  https://www.cisa.gov/publication/guidance-essential-critical-infrastructure-workforce.  The MDHHS Prioritization Guidance for Critical/Essential/Front Line Workers may change.

 
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 what best describes how you fit into Phase 1B: *This question is required.
3. If you are a critical/essential employee, please check the area that best describes your job/occupation.
  • * This question is required.
5. Please check the county that you live or work in where you plan to be vaccinated. *This question is required.
This question requires a valid email address.