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Please take a few minutes to help us with our COVID-19 vaccination plan. This is not authorization for vaccination nor will be considered a consent or declination.

We understand there are a lot of unknowns and a lot of questions we cannot answer at this point. Please help us understand what information you would find helpful as you navigate through making the best decision with your loved one about the vaccine.

Thank you, Sarah 

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* 1. As of now, do you want the COVID-19 Vaccine for your loved one?

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* 2. For all: What types of information would be helpful as you weigh the risks and benefits? Please rank with #1 being the most important, #2 second most important, etc. As information is made available to us, we will make it available to you.

  1. Facts about the actual vaccine
  2. Information about the side effects
  3. Facts about billing (you will not need to pay out of pocket)
  4. Information about the clinical trials
  5. Information about the effectiveness
  6. How the vaccine is administered
  7. What are the ramifications of getting or not getting the vaccine
  8. What reason(s) should I not get the vaccine.

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* 3. If you decide you want your loved one to have the vaccine and we know consent is needed, we expect the consent process to be expedited 'ASAP'. Do you have the ability to sign a consent form in 24 hours? (*If your loved one is able to make their own decision and can sign consent, we will have them do so.)

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* 4. If you answered no to the last question, please share what challenges do you foresee?

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