Wyoming County Public Health Vaccine Survey
RequiredRequired Question(s)
Progress: 
 
The Wyoming County Health Department would like your feedback on a few key questions related to the COVID-19 vaccine. Your help is appreciated as Public Health authorities work to find solutions, gauge vaccine demand, and develop plans for vaccine availability moving forward. Your responses are confidential.
 
Required
Please select your age group:
18-24
25-34
35-44
45-54
55-64
65-74
75 years or older
Required

Please select your gender:

Female
Male
Prefer not to answer
Other  
Required

Have you already received the COVID-19 Vaccine?

Yes
No