City of Salem preK-12 Educator & Childcare Vaccination Support Questionnaire

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City of Salem preK-12 Educators and Childcare Workers -

In an effort to support you and your access to the COVID-19 vaccine, we are reaching out to identify individuals who newly qualify for the vaccine under the state's tiered system but have not yet been able to secure an appointment. We are aware that a number of appointments will be released in the coming days and want to do everything we can to support this process.

The information below will help us help you. Your information will be shared with a volunteer who is helping to secure appointments, but will not be used for any other purposes.

For a complete list of who qualifies, please review this page from the state: https://www.mass.gov/info-details/frequently-asked-questions-covid-19-vaccinations-for-k-12-and-childcare-workers

Full Name (First and Last) *

Which best describes your role in K-12 Education? *

Teacher

Paraprofessional

School support team member (before/after school, custodian, food & nutrition, other staff member)

Administrator (Principal, AP, coaches, Districtwide - HR, finance, operations, academics, IT, etc.)

Childcare provider

Other:

Where do you work? *

Salem Public Schools

Salem Academy Charter School

Childcare center or other early childhood provider

After school or school support organization

Other:

Which best describes your current status with regards to the vaccine? *

I have gotten or secured an appointment for the vaccine

I want the vaccine but have not yet been able to get it

I am not interested in or able to get the vaccine at this time

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