Tentative Vaccination Clinic

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The Hempfield Area School District Health & Safety Plan states that the District will continue collaboration with local health care providers to communicate opportunities for vaccinations. We are surveying our school community in consideration of offering a voluntary COVID-19 vaccination clinic at the Hempfield Area High School Field House for children ages 5 and older, once approved. The purpose of this survey is to learn if sufficient interest exists for an on site clinic and if so, the estimated amount of vaccinations needed. Questions are also included to determine a most convenient time for families as parents or guardians will need to be present with children. If you have interest in having your child vaccinated at the Hempfield Area High School Field House, please complete this brief survey no later than Monday, November 1, 2021.

Email *

Parent Name *

Number of children ages 5 and older to potentially participate in the vaccination clinic for COVID-19 held at the Hempfield Area High School Field House. *

Other:

Indicate which of the following would be most convenient for your family for a potential date of the vaccination clinic. Select all that apply. *

InService Day of the afternoon of Thursday, November 11, 2021 if vaccinations are approved by this date for children age five and older.

InService Day of Friday, November 12, 2021 if vaccinations are approved by this date for children age five and older.

Saturday in November, once vaccination is approved for children ages five and older.

Sunday in November, once vaccination is approved for children ages five and older.

None of the listed dates are convenient

Potentially interested in a future date in 2022.

Other:

Required

Comments, suggestions, etc. (Optional)

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