Vaccine Interest Survey

Question Title

* 1. Please indicate your affiliation with Rockhurst University:

Student

Faculty

Staff

Question Title

* 2. Please select your age range:

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Question Title

* 3. Do you intend to receive a vaccine when it is available to you?

Yes

No

I have already received a vaccine.