NextGen User Guide Feedback Survey

Thank you for helping us improve the NextGen User Guide for HPV Vaccination (the Guide). This Guide is meant to assist Federally Qualified Healthcare Centers (FQHCs) and other clinics in preparing their Electronic Health Record system to track and promote HPV vaccination.

Your feedback is critical to ensuring that we provide a useful tool to increase HPV vaccination rates. Please provide as much detail as possible using the form below.

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* 1. Name (optional):

Please include your email below if you would like the HPV VACs team to follow-up with you.

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* 2. Email (optional):

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* 3. I am:

On the IT team at a FQHC

On a non-IT team at a FQHC

On the IT team at a private clinic or hospital system

On a non-IT team at a private clinic or hospital system

An American Cancer Society health systems staff member

A public health professional working on HPV vaccination

Other (please specify)