TEEN VACCINE FLORIDA
Home
Vaccine Information & Importance
Contact
Vaccinated Survey
*
Indicates required field
What is your age?
*
Select One
12
13
14
15
16
17
Prefer not to say, but I am a teenager
What Florida county did you get vaccinated in?
*
Select One
Alachua
Baker
Bay
Bradford
Brevard
Broward
Calhoun
Charlotte
Citrus
Clay
Collier
Columbia
DeSoto
Dixie
Duval
Escambia
Flagler
Franklin
Gadsden
Gilchrist
Gulf
Hamilton
Hardee
Hendry
Hernando
Highlands
Hillsborough
Holmes
Indian River
Jackson
Jefferson
Lafayette
Lake
Lee
Leon
Levy
Liberty
Madison
Manatee
Marion
Martin
Miami-Dade
Monroe
Nassau
Okaloosa
Okeechobee
Orange
Osceola
Palm Beach
Pasco
Pinellas
Polk
Putnam
Santa Rosa
Sarasota
Seminole
St. Johns
St. Lucie
Sumter
Suwannee
Taylor
Union
Volusia
Wakulla
Walton
Washington
Where did you get vaccinated or where are you scheduled for?
*
CVS
Walgreens
Publix
Walmart
County Health Department
Other
If Other, please specify:
*
Please provide as much specific information as possible. For example, "I called and joined a waitlist", "I scheduled an appointment online", "I went to the location and waited in line", etc.
*
Submit
Home
Vaccine Information & Importance
Contact