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Submitted URL: http://www.surveymonkey.com/r/pbcvax
Effective URL: https://www.surveymonkey.com/r/pbcvax
Submission: On September 19 via api from US — Scanned from DE
Effective URL: https://www.surveymonkey.com/r/pbcvax
Submission: On September 19 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
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<span class="radio-button-label-text question-body-font-theme user-generated "> Four Points (50 S Military Trail, Room 1N-142) - <strong><span style="color: #ff0000;">Tue</span><span
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</form>Text Content
ONSITE VACCINE CLINICS Palm Beach County Board of Commissioners will be hosting onsite vaccine clinics for employees. Cigna-insured BCC employees are eligible for vaccinations free of charge. Others should check with their carrier to determine costs (if any). Please contact the Employee Wellness Program with any questions at wellness@pbcgov.org or (561) 233-5451 QUESTION TITLE * 1. TO REGISTER, PLEASE CHOOSE ONE LOCATION/DATE: Vista Center (Hearing Chambers) - Thursday, September 22 (8am) Four Points (50 S Military Trail, Room 1N-142) - Tuesday, September 27 (8am) Governmental Center (McEaddy Conference Room) - Thursday, September 29 (8am) QUESTION TITLE * 2. PLEASE COMPLETE YOUR INFORMATION BELOW AND YOU WILL BE SCHEDULED: YOU WILL BE ASSIGNED A 30-MINUTE APPOINTMENT WINDOW IN ORDER TO BEST ACCOMMODATE ALL EMPLOYEES. First Name: Last Name: Department: Email Address: Phone Number: QUESTION TITLE * 3. I AM INTERESTED IN RECEIVING THE FOLLOWING VACCINES (CHECK ALL THAT APPLY): INDIVIDUAL COUNSELING WILL BE PROVIDED PRIOR TO ADMINISTRATION. Flu Covid-19 (new bivalent booster approved in September 2022) Shingles (ages 50+) Tdap Pneumonia (ages 65+) Hepatitis A Hepatitis B QUESTION TITLE * 4. QUESTIONS/COMMENTS: Done Powered by See how easy it is to create a survey. Privacy & Cookie Notice Javascript is required for this site to function, please enable.