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* 1. What is your name?

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* 2. Are you a mother of 2 or more children between the ages of 9-18, at least one of whom has received an adolescent vaccine (Tdap, HPV, Meningococcal ACWY, Meningococcal B

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* 3. Which category below includes your age?

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* 4. What is the highest level of school you have completed or the highest degree you have received?

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* 5. If employed, what is your job title?

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* 6. Why did you vaccinate your child with Tdap, HPV, Meningococcal ACWY or Meningococcal B vaccines?

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* 7. Can you describe an educational campaign that you have seen on vaccines?  What did you like/not like about it?

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* 8. Where do you go to get health education on the web?  Why?

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* 9. What is your email address?

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* 10. How did you hear about the Unity Consortium Mom Advisory Board?

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