JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Covid Questionnaire
We need your input!
Mayflower School District wants your honest opinion on the topic of Covid.
Please respond to this very brief survey at your earliest convenience.
The demographic information will be used only to analyze data, but not to identify individuals.
Sign in to Google
to save your progress.
Learn more
Are you the parent/guardian of a student in Mayflower School District?
No
Yes
Other:
Clear selection
On which campuses do your children attend?
Mayflower Elementary
Mayflower Middle School
Mayflower High School
I do not have currently have children attending Mayflower School District
Please denote your age range.
Below 20
20-29
30-39
40-49
50-59
60+
Clear selection
Have you been vaccinated?
Yes
No
Clear selection
If you have not been vaccinated, what is your reason for choosing not to do so?
Your answer
Have your children been vaccinated?
Yes
No
Clear selection
Regarding vaccination of children, why have you chosen to vaccinate your children or not?
Your answer
Do you believe masks should be required for students?
Yes
No
Clear selection
Do you believe masks should be required for employees?
Yes
No
Clear selection
Please provide additional input with your thoughts regarding masks for students and/or employees.
Your answer
What is your level of concern regarding the potential for transmission of Covid for employees while at work?
Not concerned
1
2
3
4
5
6
7
8
9
10
Very concerned
Clear selection
What is your level of concern regarding the potential for transmission of Covid for students while at school?
Not concerned
1
2
3
4
5
6
7
8
9
10
Very concerned
Clear selection
Please provide any additional thoughts you currently have on the topic of Covid that might be helpful.
Your answer
If you do have a child currently enrolled in Mayflower School District who has already been vaccinated, it would be appreciated if you would provide their information (First name, last name, current grade).
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mayflower Schools.
Report Abuse
Forms
