Cecil County Provider COVID-19 Vaccination Survey
The Cecil County Health Department is preparing for the distribution of COVID-19 vaccine in the county. We would appreciate your input regarding your facility's interest in receiving the vaccine to help inform our planning. Once vaccine is available we will contact your facility to arrange for vaccine distribution.  Please complete the survey by Friday January 8, 2021. Thank you.
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Respondent Name: *
Organization Name: *
Address: *
Contact Person: *
Phone Number: *
Email Address: *
Preferred Contact Method: *
Required
Please select the type of practice that best describes your facility. *
How are patients seen at your facility? Check all that apply. *
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