COVID Vaccination Survey for Parents

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Greene County Department of Public Health representatives have made us aware that they may be able to come to Catskill School District to administer COVID vaccine(s) to our students who are 12 years or older if there is sufficient interest. The purpose of this survey is to poll our parents to see who might be interested in having their child vaccinated. Thank you, in advance, for participating in this survey.

I am interested in having my child, who is 12 years of age or older, receive the COVID-19 vaccination. *

Yes

If yes, please complete the information below:

Student's Name: *

Age: *

Name of Parent completing the survey: *

Phone Number: *

Email Address: *

Submit

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