Someone You Love - The HPV Epidemic Individual Survey

Toolkits help us navigate the complexities in modern healthcare

Someone You Love- The HPV Epidemic Individual Evaluation Survey

Your feedback is much appreciated.  Please take a few minutes to complete this short survey.

1. Please rate the film on a scale of 1 to 5 with 5 being excellent:
2. I am a: (Check all that apply)
3. Age
4. Before seeing the film how supportive of HPV Vaccine, were you?
5. After seeing the film how supportive of HPV Vaccine, were you?
6. Have I or my daughter (age 11 and older) already had:
7. Have I or my son (age 11 and older) already had:
8. After seeing the film, I will: (Check all that apply)