Surveys 2016 August I Immunization of Children

Immunization of Children

0%

Exit Survey

Hello: You are invited to participate in a survey about Immunization of Children. In this survey, approximately 50 people will be asked to complete a survey that asks questions about immunization of children. It will take approximately 2 minutes to complete the questionnaire. Your participation in this study is completely voluntary and anonymous. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions. Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Brandy Hunter at email at the email address specified below. Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.  I Agree       Do you have any children?   Yes   No   Currently Pregnant   Currently Trying   Other         How many children do you have?       Were you vaccinated as a child?   Yes   No   Not Sure       Do you plan on vaccinating your children?   Yes   No   Prefer Not Answer       Have you ever been diagnosed with a disease as a child that could have been vaccinated against?   Yes   No   Not Sure   Prefer Not Answer       What disease, if any, have you been diagnosed with as a child that had a vaccination (Select all that apply)?   Diphtheria   Tetanus   Pertussis (Whooping Cough)   Hepatitis A   Hepatitis B   Hib – Haemophilus influenzae type b (Hib Meningitis)   PCV – Pneumococcal disease   Polio – Inactivated polio virus vaccine   RV – Rotavirus   Measles   Mumps   Rubella   Varicella (Chickenpox)   None   Not Sure   Other         What type of Health Insurance do you have?   Humana   Blue Cross Blue Shield   Blue Anthem   Aetna   Golden Rule   Care Plus   United   Humana One   Care Plus   Obama Care   Medicaid   Medicare   AARP   Passport   Kynect   Other         Are you?   Male   Female   Other         About how much do you make annually?   0 - 20,000   21,000 - 50,000   51,000 - 75,000   76,000 - 90,000   91,000 - 115,000   116,000 - 145,000   146,000 - 165,000   166,000 - 185,000   186,000 - 200,000   Over 200,000   Prefer Not Answer   Other