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JCHD COVID-19 Vaccine Interest Survey
JCHD COVID-19 Vaccine Interest Survey
Based on availability, and guidance from the Missouri Department of Health and Human Services (MO DHSS) and the Center for Disease Control (CDC), the Jefferson County Health Department will be providing the COVID-19 vaccine based on a pre-determined tier system. Individuals will be identified to receive the vaccine based on risk status and occupation. Once the vaccine is made available for your tier, the Jefferson County Health Department will use your information from the survey below to contact you with further instructions on how to schedule an appointment to receive your vaccination. Per the guidance provided by the CDC, COVID-19 vaccinations will not be provided to those under the age 16. 
20Questions
JCHD COVID-19 Vaccine Interest Survey
Language
  • English (US)
  • Español
  • 1
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  • 2
    • 63010 (Arnold)
    • 63012 (Barnhart)
    • 63087 (Bloomsdale)
    • 63628 (Bonne Terre)
    • 63015 (Catawissa)
    • 63016 (Cedar Hill)
    • 63019 (Crystal City)
    • 63020 (De Soto)
    • 63023 (Dittmer)
    • 63025 (Eureka)
    • 63026 (Fenton)
    • 63028 (Festus)
    • 63030 (Fletcher)
    • 63041 (Grubville)
    • 63047 (Hematite)
    • 63048 (Herculaneum)
    • 63049 (High Ridge)
    • 63050 (Hillsboro)
    • 63051 (House Springs)
    • 63052 (Imperial)
    • 63053 (Kimmswick)
    • 63057 (Liguori)
    • 63065 (Mapaville)
    • 63066 (Morse Mill)
    • 63069 (Pacific)
    • 63070 (Pevely)
    • 63072 (Robertsville)
    • other
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  • 3
    Press
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  • 4
    Pick a Date
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  • 5
    Press
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  • 6
    Press
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  • 7
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  • 8
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  • 9
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  • 10
    • Hospital
    • Long Term Care Facility
    • Home Health
    • Urgent Care
    • Physicians Office
    • Behavioral Health
    • Dialysis Center
    • Outpatient Healthcare
    • Other Healthcare
    • School District Nurse
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  • 11
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  • 12
    • Federal, State, or Local health agency
    • Law Enforcement
    • Fire Services
    • Emergency Medical Services (EMS)
    • Corrections
    • Social Service Agency
    • Emergency Management
    • Public Works
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  • 13
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  • 14
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  • 15
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  • 16
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  • 17
    • Education
    • Childcare
    • Communications Infrastructure
    • Dams Sector
    • Energy Sector
    • Food and Agriculture Sector 1
    • Government
    • Information Technology
    • Nuclear Reactor Sector
    • Transportation Systems
    • Water and Wastewater systems
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    Enter
  • 18
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  • 19
    • Commercial Facilities Sector
    • Critical Manufacturing
    • Defense Industrial Base
    • Financial Services
    • Food and Agriculture Sector 2
    • Government
    • Disproportionately Affected Populations
    • Homeless
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  • 20
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  • Should be Empty:
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