UPMC Children's Hospital COVID Vaccine Survey
Please fill this form out if you are interested in a COVID vaccine for your child.
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We have a COVID Vaccine Clinic set up for January 14, 2022 from 3pm-5pm at DRE for any student between the ages of 5-12. Would you be interested in participating? A parent MUST be present with the child while they are administered the injection.
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Name of Student(s)
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Parent's email address
Parent's cell #
More information will be sent out once we see how many are interested, please indicate any questions or concerns that you may have for the nurse.
A copy of your responses will be emailed to the address you provided.
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