Hi girls. I am surveying for a biology class Im taking. Would you mind taking it? Its quite a few questions but simple answers, easy stuff. Girls with Babies, please feel free to do a survey for your little ones.
Influenza Vaccination Survey
1. Select Your Current Age Range:
____ 6mos-12yrs ___22yrs-35yrs ___56yrs-70yrs
____13yrs- 21yrs ___36yrs- 55yrs ___70yrs- 95yrs
2. Select One:
___ Male ___Female
3. Are You Pregnant?
___Yes ___No
4. Have you ever experienced influenza?
___ Yes ___No
5. Have you ever been vaccinated?
___Yes ___No
6. In which years have you chosen to vaccinate?
7. Do you have health conditions that require you to vaccinate, if so, which ones?
8. Does your work environment require you to vaccinate? If so, why?
9. Have you experienced flu-like symptoms post vaccination?
10. Which form of the vaccination do you prefer?
___Nasal Spray ___Injection ___Other (please explain)
11. Have you noted a difference in side effects if you?ve experienced multiple types of vaccinations? (Please Explain)
12. Have you noted different side effects from different vaccinations from year to year? (Please Explain)
13. If you are over the age of 65yrs do you know that you are to have a higher concentrated vaccination? Have you had this ?
14. Will you choose to vaccinate this year? Why?
15. If you?ve chosen not to vaccinate, why?
16. How Informed are you about the 2011-12 Influenza strain and vaccination?
Ad?Any questions?
Thank You!
Re: Influenza Survey
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Sure! allthatjazz206 AT yahoo dot com
Thanks so much!! I really appreciate it!
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