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Vaccination Survey
Name
Click to add
(?)
Dental License Number
Click to add
(?)
Email Address
Click to add
(?)
Daytime Telephone Number
Click to add
(?)
Are you a dentist in active practice?
Yes
No
Age Group?
20-30
30-50
50-65
65+
In which county do you practice?
Broward
Miami Dade County
Have you received the first dose of the COVID-19 Vaccine?
Yes
No
Which Vaccine?
Pfizer
Moderna
Neither
If you have not done so, do you wish to receive vaccine?
Yes
No
If you have attempted to make an appointment to receive the vaccine, has your experience been:
Successful
Attempted, but no luck
Haven't tried
Where have you attempted?
Hospital
Public health department
Physician's Office
Large open site
Other
Has any of your office staff received the vaccine?
Yes
No
How many staff members are employed at your office?
Click to add
(?)
Would you like to continue receiving updates on the vaccine roll out in South Florida?
Yes
No
About Us
Who We Are
Leadership
Staff
Other Affiliated Organizations
FDA
ADA
Other Components
FL Board of Dentistry
FDA Foundation
FDA Services
Flouridation Websites
Florida's Mission of Mercy
Member Center
Join Us
“Ain’t That the Tooth” Podcast
Benefits
Industry Solutions
SFDDA Bylaws
ADA Events
Subscribe and Be Informed
Vaccination Survey
Master Calendar
Free Webinars Available to Members
Publications
Advertising in SFDDA Newsletter
Classified Ads
Employment
Job Seeker-Register
Opportunities Available
Post a Job
Resume Pool
Dental License Renewal
Sponsors
Member Resources
Do’s and Don'ts of Dental Advertising
Leadership
Student / Early Career Resources
Advocacy
Dentists' Day on the Hill
Florida Action for Dental Health
Meetings & CE
WE'RE TAKING A MULLIGAN!
CE Broker/BOD FAQs
FDA Online CE
Florida Dental Convention
America's Dental Meeting
Public
Access to Care Resource Guide
Additional Resource for Aging Adults
Low-Cost Dental Care
Dental Health FAQ
FL Action for Dental Health
File a Complaint
The Importance of Water Flouridation
Why Choose an FDA Member Dentist
Employment
Dental Specialities
Careers in Dentistry
Dentist
Hygienist
Dental Assistant
Dental Lab Technician
Career Resources
Florida Dental Schools
FAQs
Other Helpful Links
Student/Resident Resources
Affiliate Corner
Foundation
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