COVID 19 Vaccine Symptom Report

Thank you for your reporting any symptoms you've had after receiving the COVID Vaccine.
A CDC computer rendering of the surface of SARS-CoV-2

 

Have you had any of these symptoms where you got the shot (injection site)?





Have you experienced any of these symptoms today?

 








Any other symptoms or health conditions you want to report?

How would you rate your symptoms today?



Did any of the symptoms or health conditions you reported today cause you to:
Select all that apply



Do you want Employee Health to call you back?