BYO Covid-10 Survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

BYO Covid-10 Survey

This survey and its results will be kept confidential

* Indicates required question

Email *

Your email

Have you (BYO Member) been vaccinated for Covid-19? *

I have had the first shot

I have had the second shot

I had the J&J 1-shot Vaccination

I have not had a vaccine shot

I consider myself immune because I have already had covid

Required

Has your spouse or significant other been vaccinated for Covid-19?

Had 1st shot

Had 2nd shot

Had J&J 1-shot vaccination

Has not been vaccinated

Considered immune because already had covid

Submit

Page 1 of 1

Clear form

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy