COVID-19 Vaccine Poll
Job Position
Department
Age
Gender
Male
Female
Please select the applicable options below:
I currently live with a child below 18 years old
I currently live with a person that is immunocompromised
I currently live with a senior citizen
Once COVID-19 vaccine becomes available, would you like to get vaccinated?
Accept
Decline
Not yet sure
What is the reason why you want to be vaccinated?
What is the reason why you don't want to be vaccinated?
What is the reason why you are not yet sure if you want to be vaccinated or not?
Are you willing to be vaccinated once the issues you're referring to were addressed?
Yes
No
Submit
Should be Empty: