Vaccination Survey

Are you a dentist in active practice?

Age Group?



In which county do you practice?

Have you received the first dose of the COVID-19 Vaccine?

Which Vaccine?


If you have not done so, do you wish to receive vaccine?

If you have attempted to make an appointment to receive the vaccine, has your experience been:


Where have you attempted?




Has any of your office staff received the vaccine?

Would you like to continue receiving updates on the vaccine roll out in South Florida?




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