Pursuant to a federal mandate, Seven Hills Foundation & Affiliates must survey all employees regarding their vaccination status.

Please complete this survey as soon as possible. If you have any trouble completing the survey or submitting your COVID-19 vaccination card please see your supervisor for assistance.

For purposes of this form, you are considered “fully vaccinated” two weeks after completing the second dose of a two-dose COVID-19 vaccine (e.g., Pfizer or Moderna) or two weeks after receiving a single dose of a one-dose vaccine (e.g., Johnson & Johnson/Janssen).

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* 1. Please select your vaccination status.

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