COVID-19 Vaccination Survey
MCNJ is planning to set up Covid testing and vaccination center at our location for easy access to our community members. We are requesting you to please take a few minutes to respond to the questions below.

Jazakum Allah Khairan
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Name: *
Phone Number *
Email Address *
Age *
Were you infected with Corona Virus (Covid-19) in the last three months *
Did you take any of the Covid Vaccination? *
If no for above question are you planning to take Covid vaccination in near future? *
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