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Vaccination Survey 10-21-21
1.
Name
2.
Phone Number
3.
Company
4.
Email
*
5.
Zip Code of your Restaurant/Company
(Required.)
*
6.
What percentage of your employees are vaccinated or have taken at least one dose?
(Required.)
0-10%
10-20%
30-40%
50-60%
70-80%
90-100%
*
7.
Of your staff that is not vaccinated, what is your best guess as to the reason why.
(Required.)
0-10%
10-20%
30-40%
50-60%
>70%
Religious
0-10%
10-20%
30-40%
50-60%
>70%
Medical Exemption
0-10%
10-20%
30-40%
50-60%
>70%
Personal Belief
0-10%
10-20%
30-40%
50-60%
>70%
Other (please specify)
*
8.
Are you already mandating all employees to be vaccinated?
(Required.)
Yes
No
*
9.
Are you considering mandating your employees to be vaccinated?
(Required.)
Yes
No
If no, explain the reason
*
10.
What support do you need to get to a higher percentage of vaccination among your employees
(Required.)
*
11.
Would your employees feel safer coming to work if guests were required to be vaccinated?
(Required.)
Yes
No
*
12.
Would guests feel safer going to a restaurant with 100% vaccination among the restaurant’s employees
(Required.)
Yes
No
*
13.
Would your employees feel safer knowing that their fellow co-workers are vaccinated?
(Required.)
Yes
No
*
14.
What % of your revenue have you lost in September/October 2021 compared to EITHER the same period in 2019 OR compared to July/August 2021?
(Required.)
0%-10%
10-20%
30-40%
40-50%
50-60%
>70%
None
*
15.
What % of your employees have you lost in September/October 2021?
(Required.)
0-10%
10-20%
30-40%
40-50%
50-60%
>70%
None
Mahalo,
Sheryl Matsuoka
Executive Director
Hawaii Restaurant Association
2909 Waialae Ave #22
Honolulu, HI 96826
info@hawaiirestaurant.org
