NCMS COVID-19 Vaccine Survey

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* 1. Have you received a COVID-19 vaccine yet?

Yes

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* 2. If you have not received the vaccine, do you plan on receiving it?

Yes

Already received the vaccine

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* 3. Do you believe the COVID-19 vaccines that are currently available are safe?

Yes

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* 4. Will you be recommending the COVID-19 vaccine to patients?

Yes

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* 5. Do you have necessary information to provide to patients about the science of the vaccine?

Yes

Any comments or suggestions:

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* 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

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* 7. Do you have a vaccination policy for your staff? (i.e. are you requiring staff to be vaccinated?)

Yes

Not applicable

Any additional comments or concerns

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* 8. What is your current practice model.

Independent

Affiliated with health system

Other (please specify)

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* 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)

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* 10. Does your practice want to serve as a COVID-19 vaccination location?

Yes

NCMS COVID-19 Vaccine Survey

Question Title

* 1. Have you received a COVID-19 vaccine yet?

Question Title

* 2. If you have not received the vaccine, do you plan on receiving it?

Question Title

* 3. Do you believe the COVID-19 vaccines that are currently available are safe?

Question Title

* 4. Will you be recommending the COVID-19 vaccine to patients?

Question Title

* 5. Do you have necessary information to provide to patients about the science of the vaccine?

Question Title

* 6. Do you have the necessary information about where in the vaccination prioritization plan you, your staff and your patients can receive the vaccine?

Question Title

* 7. Do you have a vaccination policy for your staff? (i.e. are you requiring staff to be vaccinated?)

Question Title

* 8. What is your current practice model.

Question Title

* 9. What are your biggest challenges in COVID-19 vaccination efforts at this point?

Question Title

* 10. Does your practice want to serve as a COVID-19 vaccination location?

Question Title

* 11. What other information regarding the COVID-19 vaccine would you like us to know? How can NCMS assist you and your practice?