NCMS COVID-19 Vaccine Survey
1.
Have you received a COVID-19 vaccine yet?
Yes
No
2.
If you have not received the vaccine, do you plan on receiving it?
Yes
No
Already received the vaccine
3.
Do you believe the COVID-19 vaccines that are currently available are safe?
Yes
No
4.
Will you be recommending the COVID-19 vaccine to patients?
Yes
No
5.
Do you have necessary information to provide to patients about the science of the vaccine?
Yes
No
Any comments or suggestions:
6.
Do you have the necessary information about where in the vaccination prioritization plan you, your staff and your patients can receive the vaccine?
Yes
No
7.
Do you have a vaccination policy for your staff? (i.e. are you requiring staff to be vaccinated?)
Yes
No
Not applicable
Any additional comments or concerns
8.
What is your current practice model.
Independent
Affiliated with health system
Other (please specify)
9.
What are your biggest challenges in COVID-19 vaccination efforts at this point?
Getting access to the vaccine for myself and my staff
Coordinating with hospitals and health departments
Getting access to the vaccine for patients
Keeping up with new science/data/side effects of the vaccines
Enrolling as a vaccine provider in CVMS or challenges navigating CVMS system
Other (please specify)
10.
Does your practice want to serve as a COVID-19 vaccination location?
Yes
No
11.
What other information regarding the COVID-19 vaccine would you like us to know? How can NCMS assist you and your practice?
Current Progress,
0 of 11 answered
