COVID-19 Vaccine Questionnaire

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La Joya ISD is requesting input from employees regarding the COVID-19 vaccine in order for our district to continue facilitating vaccines for employees. This voluntary survey will assist La Joya ISD in the decision-making regarding employee and student safety; however, the results of this survey will not be the only information used in the decision-making process. All information gathered in this survey related to employee’s medical information will remain confidential.

Email *

Last Name: *

First Name: *

Employee ID#: *

Campus/Department: *

1. Have you taken the COVID-19 Vaccine? *

Yes

2. If you have not yet taken a COVID-19 Vaccine, do you plan to get it?

Yes

N/A

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