COVID Testing and COVID Vaccine Community Knowledge and Acceptance Survey

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* 1. Have you had a COVID Test ?

Yes

If Yes how many times ?

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* 2. If No why have you not yet had a COVID Test ?

Did not feel that I needed a test unless I felt sick

Scared of the test/ Thought it would be painful

Not able get to find a testing site

Need to work and can't quarantine if positive

Other

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* 3. Which type of COVID Test would you prefer?

Anterior Nasal Swab

Oral Cheek Swab

Nasopharyngeal Swab

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* 4. Are you planning to take the COVID Vaccine?

Yes

Not Sure

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* 5. Are you comfortable that the COVID Vaccine is safe and needed?

Yes

Not Sure

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* 6. Do you feel you have enough knowledge about COVID and the Vaccine?

Yes I have enough knowledge

I need more information about the COVID Vaccine

I need more information about COVID, COVID Testing and the COVID Vaccine

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* 7. Check the statements below which are true?

The COVID Virus is just a cold

The COVID Test is not very accurate

America has the most people dying from COVID worldwide

No one is dying from COVID

Wearing Masks, washing your hands and staying 6 feet apart can prevent COVID infections

The COVID Vaccine is not safe and may harm you

The COVID Vaccine is only 1 injection

The COVID vaccine will be mandatory for everyone

The COVID Vaccine has a tracking device in it

You should stay home after getting a COVID test and until your results come back

There are no resources for people who test positive with the COVID virus

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* 8. Would you like more information on COVID, COVID Resources or Telehealth Acces?

Yes

Maybe

Your Zip Code and Contact information Here:

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* 9. What is your race ?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

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* 10. What is your sex and Your Age Range?

Male

Female

LGBTQ

Other

Age 5- 9

Age 10- 15

Age 16- 19

Age 20 - 30

Age 31- 40

Age 41-60

Age 61-70

Over age 71