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Immunizations and Vaccinations

Vaccine Survey

If you received your COVID-19, influenza (flu) or other type of vaccine from us, we'd love to hear from you. Please complete this anonymous survey. Your answers will be confidential. The feedback and information will help us improve our service, and the way we outreach in our communities. Thank you for your time.


How easy or difficult was it to fill out your paperwork?
How satisfied were you with the check in process?
How long did you have to wait to receive your vaccine?
How satisfied were you with your overall experience?
Where do you typically go for your vaccines?
Have you received at least one COVID-19 shot?
Have you had, or do you plan on getting, your flu vaccine?
How concerned are you about getting COVID-19?
How worried are you about getting severely ill due to COVID-19?
Have you received the newest COVID-19 vaccine?
If not, why not?
On a scale of 1 - 5, with 1 being the LEAST safe, and 5 being the MOST safe, how safe do you think the COVID-19 vaccines are?
Where do you get information about the COVID-19 vaccine? (Please check all that apply).
How trustworthy are public health agencies like East Central that recommend COVID-19 vaccines?
What is your age?
Are you Hispanic/Latino?
Which county do you live in?
Which vaccine(s) did you get from East Central? Please check all that apply.
If you answered "other vaccines," which ones?
May we use your answers in our vaccine promotion campaign? You will remain anonymous. No names will be used.