Purpose of Survey

Cochise Health & Social Services is working to identify all individuals in Cochise County who need to have a vaccination team bring the COVID vaccine to their home.  We are using the following definition for homebound and will require documentation.  “Persons who are bed bound and/or with multiple co-morbidities and require *medical transportation for leaving their home. This may be due to illness or injury.”  Medical transportation does NOT include services like Lyft or Uber.

If you or your loved one does not meet this definition you are not eligible for a home visit from the vaccination team.

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* 1. Do you, or the person you are responding for, have a disability as defined by the Americans with Disabilities Act (ADA), including intellectual/developmental, physical, mental health, and/or sensory disability?

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* 2. If you, or the person you are responding for, were provided transport would you/they be able to get to one of the vaccine points of dispensing (POD) sites?

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* 3. Do you, or the individual you are seeking homebound services for, require medical transport to leave the home?