Flu Shot Survey
*
1
. Have you had a flu shot in 2011/2012
Have you had a flu shot in 2011/2012
yes
no
*
2
. Have you had a flu shot in 2012/2013
Have you had a flu shot in 2012/2013
yes
no
*
3
. Do you plan on getting a flu shot in 2013
Do you plan on getting a flu shot in 2013
yes
no
*
4
. Have you or your family members had the flu this year
Have you or your family members had the flu this year
yes
no
Powered by
SurveyMonkey
Check out our
sample surveys
and create your own now!
Javascript is required for this site to function, please enable.