Wisconsin Literacy COVID-19 Vaccine Outreach Survey Question Title * 1. What is your zip code? Question Title * 2. What is your ethnicity or race? Native American/Alaska Native Native Hawaiian/other Pacific Islander Hispanic/Latino(a) Multi-racial Asian Black/African American White Other (please specify) Question Title * 3. What is your age? Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 4. Do you plan to get the vaccine? Yes No I don't know I already got the vaccine. Question Title * 5. Will you share the information from this session with others? Yes No I don't know Question Title * 6. If you will share this information with others, who will you share it with? (family, friends, neighbors) Done