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* 1. Do you plan on being immunized with the COVID-19 vaccine when it becomes widely available?

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* 2. Are you concerned about the safety and efficacy of the COVID-19 vaccine?

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* 3. Does your staff want to receive the COVID-19 vaccine when it becomes widely available?

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* 4. Is your staff concerned about the safety and efficacy of the COVID-19 vaccine?

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* 5. Are your patients asking questions about the safety and efficacy of the vaccine?

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* 6. Can you estimate what percent of your patients are likely to get the vaccine?

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* 7. What do you view as the biggest obstacle in getting New Yorkers vaccinated? 
Choose all that apply.

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* 8. Messaging:  What do you recommend as the most effective messaging means of communication for those patients who are hesitant to get the vaccine?
Choose all that apply.

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* 9. Vaccine Distribution:  Along with traditional immunizers, the state will be directing and supervising regional and local Points of Distribution (PODs) to administer vaccinations, the size and set-up of these PODS will vary according to geographic area, vaccine supply and other factors.

What should the state be considering regarding the credibility and acceptance of these efforts, as well as in terms of their effective and efficient operations?  Choose all that apply.

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* 10. Access:  What are you most concerned about as it related to the equitable access to the vaccine?

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* 11. What county are you in?

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* 12. What is the size of your practice?

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* 13. What is your speciality?

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