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Thank you for choosing PHD as your COVID-19 vaccine provider! We appreciate you providing feedback so we can continually improve our process.

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* 1. Please rate the quality of the service you received from PHD staff and volunteers?

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* 2. Did you have to schedule time off work, arrange for childcare, or other accommodations to make it to your appointment?

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* 3. How many people do you know who have received a COVID-19 vaccine? (Moderna/Pfizer/Johnson & Johnson)

  Number
Family
Friends
Co-workers

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* 4. How did you hear about PHD's vaccine clinic? Check all that apply.

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* 5. How familiar are you with other services PHD offers?

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* 6. What PHD services have you used in the past 12months? Check all that apply.

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* 7. Did you know that PHD offers services to those with and without insurance?

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* 8. Please rate the following from 1 (Strongly Disagree) to 5 (Strongly Agree)

  Strongly Disagree Strongly Agree
PHD is a trustworthy organization.
I am confident in the services PHD provides.
I use PHD services before I look for other options.
I would recommend PHD to my friends and family.

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* 9. Are there barriers to receiving our services? Check all that apply.

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* 10. Please share any additional comments, suggestions, or questions about the vaccine clinics or PHD in general.

0 of 10 answered
 

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