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Health Fair

Please submit by November 14, 2021

St. Joseph the Worker Holiday Health Fair Survey

Holiday Health Fair COVID and FLU vaccines Health information and Screenings Giveaways and Gifts

Would you attend a Health Fair at Saint Joseph the Worker on December 4, 2021?*
- Yes
- No
If yes, select the adult & adolescent services you would like the Health Fair to provide?
- COVID vaccine (ages 16 & up) 1st Dose
- COVID vaccine (ages 16 & up) 2nd Dose
- COVID vaccine (ages 16 & up) Booster
- Flu vaccine
- Nutritional Education
- Mental (Behavioral) Health Screening
- Medicare Counseling
- Health Screening (blood pressure & blood sugar)
- Gifts & Giveaways
- Pharmacist consultation regarding the COVID vaccines & your prescribed medication.
Select the child & adolescent services you would like the Health Fair to provide? (Parent or legal guardian must be present)
- COVID vaccine (ages 5 to 11)
- COVID vaccine (ages 12 to 17)
- Mental (Behavioral) Health Screening
- Vision Screening
- Hearing Screening
- Nutritional Counseling
- Gifts & Giveaways
- Santa Visit at the Fair

Thank you for taking time to complete this survey!

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