As part of our COVID Recovery work with young people, Youth Action is keen to facilitate access to COVID-19 vaccinations for young people. This survey will help us and Ministry of Health determine appropriate support for young people accessing vaccinations. 

If you have further questions, please contact us at info@youthaction.org.au

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* 1. Name

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* 2. Organisation

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* 3. Contact email

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* 4. Contact phone (optional) 

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* 5. Which Local Health District do you work in? (if you work across multiple LHDs, please tick all that apply).

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* 6. Which age ranges do you work with? Tick all that apply

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* 7. Which groups of young people do you predominantly work with? Tick all that apply.

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* 8. Would young people in your area benefit from a mobile vaccination clinic?

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* 9. Where would be the best site(s) for this mobile clinic to occur? Tick all that apply.

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* 10. If Other, please indicate where that would be.

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* 11. Are you the best person to contact about arranging this?

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* 12. If no - can you provide the details for who to contact: name/contact email and phone/organisation/address

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* 13. Is there any other information you would like us to know?

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