User Feedback Form

*How satisfied are you in using the Influenza Self-Reporting tool to report your status?

 

Very dissatisfied
 
Neutral
 
Very satisfied
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4
5

The process of reporting my flu vaccination was very easy and quick

 

Strongly disagree
 
Undecided
 
Strongly agree
1
2
3
4
5

“Do you have any suggestions for improving this tool? Please also use this space to expand on any answers above.”