The following survey is designed to assess your view toward receiving vaccinations for COVID-19. Your responses will assist Floyd County Public Health and Floyd County Emergency Management for vaccine planning.

Question Title

* 1. What is Your Age

0-18

19-39

40-59

60-79

80+

Question Title

* 2. What is your Gender?

Male

Female

Or Other

Question Title

* 3. Do you plan to receive a COVID19 vaccine when it becomes available?

Yes

No

If No Why?