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COVID-19 Vaccination ...
COVID-19 Vaccine
COVID-19 Vaccine
This questionnaire is designed to gather information regarding your readiness for COVID-19 vaccination, and offer guidance and instruction to ensure your safety.
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Welcome!
Do you have a registration code?
Do you have a registration code?
No
Do you have a registration code?
Yes
Bookable Resource Id
*
Registration Code
*
Pod Invitation
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Are you registered with us?
Are you registered with us?
No
Are you registered with us?
Yes
Internal Session Id
*
First Name
*
POD Check Restriction
*
Middle Name
*
Booking During Registration?
Booking During Registration?
Inactive
Booking During Registration?
Active
Last Name
*
Email Address
*
*
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Year
*
