COVID-19 Vaccinations by Rite Aid
This survey is designed to help Rite Aid prepare for the vaccination clinic at the Hempfield Area High School Field House on Tuesday, May 4, 2021, from 3:00 PM to 7:00 PM.  Please complete the survey only one time for the student and/or any family members attending.
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电子邮件地址 *
Number of individuals planning to receive a vaccination. *
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切勿通过 Google 表单提交密码。
此表单是在 Hempfield Area School District 内部创建的。 举报滥用行为