Booster Clinic Survey

In preparation for the Omicron variant, Valley Senior Living needs to gather an approximate number of employees that will participate in an onsite booster clinic.

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* 1. Have your received your COVID-19 booster vaccine? (If answer is YES, please turn in your paperwork to HR and skip to questions 3 and 4.)

Yes

No

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* 2. If you have not received your booster vaccine, can we count on you to attend a booster clinic at Valley Senior Living in January?

You are eligible if it has been more than six months since your last Pfizer or Moderna dose or two months since your J & J dose.

Yes

No

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* 3. Name?

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* 4. Care Community where you work?