Influenza_Vacc_reporting

Annual Influenza vaccination is an important part of your health care.
We appreciate the time you are taking to report your vaccination status.

* Last Name

* First Name

* What is your date of birth?

* What is your vaccination status?

Are any of the following items obstacles or barriers for getting the flu shot ?(Check all that apply)

I don't have the time to get the shot

The shot is too painful

I get flu-like symptoms from the shot

Flu shots are too expensive

I can't find anyone to give me the flu shot

If you have chosen to refuse the flu shot, what is your reason?

University of Michigan