Question Title

* 1. What is the name of the Assisted Living Community you are doing business as?

Question Title

* 2. Certification Number:

Question Title

* 3. What Kentucky county is your facility located?

-All questions below will require a whole number as a response-

Question Title

* 4. How many residents are in your facility? 

Question Title

* 5. Of those residents, how many have been fully vaccinated against Covid-19?

Question Title

* 6. How many residents have only received the 1st dose?

Question Title

* 7. How many staff are employed in your facility?

Question Title

* 8. Of those staff members, how many have been fully vaccinated against Covid-19?

Question Title

* 9. How many staff members have only received the 1st dose?

T