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Vaccine Completion Survey for Congregate Care

Organization Details

As part of the Commonwealth’s continued efforts to ensure all Congregate Care and Shelter sites receive the vaccine they need, as quickly as possible, we are requesting that your organization complete a brief (~5 minute) survey once per week. Our goal is to support your completion of initial vaccination efforts by March 31st and to support ongoing vaccination needs after that time.

This survey is intended to show a high-level view into the vaccination progress each of you are making. By completing this survey, you will help the Commonwealth:
  1. Ensure all Congregate Care and Shelter sites are receiving the support they need, and
  2. Ensure the Commonwealth can continue to prioritize our vaccine allocations appropriately.
Please strive to submit one survey for your entire organization once per week. All survey submissions submitted by the end of day on Friday will be incorporated into vaccine tracking efforts in the following week- your organization's most recent survey will be used each week, regardless of when it was submitted.

This survey is intended to require only a few minutes of your time. When precise numbers are not readily available, please provide your best estimations for all questions.
Please select from the dropdown list. Begin typing your organization name to locate
2. Submitter Information: *This question is required.
This question requires a valid email address.
This question requires a valid number format.
Please list the number of unique residential Congregate Care and Shelter sites which your organization operates This question requires a valid number format.
This question requires a valid number format.
**Eligible residents include all Congregate Care and Shelter Residents over the age of 16 This question requires a valid number format.
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