Opportunity for Vaccination

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Opportunity for Vaccination

Counties Manukau Health (CMDH) are going to set up a vaccination centre in our hall for tamariki aged 5 -11 and for any adults who want vaccinations or boosters.

Sign in to Google to save your progress. Learn more

* Indicates required question

Would you be interested in using this centre? *

YES

NO

Would the times between 2.00pm and 6.00pm suit your family? *

YES

NO

Are Monday and Tuesdays suitable days ? *

YES

NO

How many adults would be coming in your whanau? *

1

2

3

4

5

Other:

How many children would be coming in your whanau? *

1

2

3

4

5

Other:

Would you like to be vaccinated in the *

CAR

HALL

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Holy Cross Catholic School Papatoetoe. Report Abuse