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Fight the Flu Campaign Survey
Please complete a brief survey about your facility’s efforts to vaccinate staff, PPE supply and testing vendor for residents. Your feedback will help Mass Senior Care gauge how to best assist our members with the Fight the Flu initiative.
1.
Facility and Contact Information
Your Name:
Your E-Mail Address:
Nursing Facility/Organization:
City/Town:
Number of Staff:
Number of Residents:
*
2.
Has your facility begun to offer flu vaccinations to staff this season?
(Required.)
Yes
No
If not, why?
*
3.
How is your facility offering flu vaccinations to staff? (Please check all that apply.)
(Required.)
Provide flu vaccination at shift change
Provide flu vaccination by request or on-demand
Partner with local public health agencies to offer flu clinics at the facility
Partner with local pharmacy to offer flu clinics at the facility
Offer flu vaccination at the same time as staff surveillance testing
Other (please describe)
*
4.
Will your facility be able to ensure that all personnel are vaccinated against influenza virus by December 31, 2020?
(Required.)
Yes
No
If no, please identify barriers to reaching this goal.
5.
Does your facility need assistance from Mass Senior Care to meet this goal?
Yes
No
