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Winter vaccination survey

Please fill out the below to help us evaluate our winter vaccination communications campaign. 

Please note that all feedback and comments provided to us with this survey will be anonymous and will help us inform our winter vaccination communication campaign. Any data provided to us (such as your email address) will only be accessed by our NHS South East London communications and engagement team and will be used for the purpose of entering our prize draw only.

By completing the survey and agreeing to share your email, you will be entered into our prize draw. One winner will be chosen at random and will receive a £50 Love to Shop voucher. We are committed to protecting your privacy. By providing your email address, you agree to the collection of this information for the purpose of entering our prize draw only. Your email address will be collected solely for this purpose. Once the draw is complete, your data will be deleted promptly. You have the right to withdraw your consent at any point. If you wish to withdraw, please email us at communications@selondonics.nhs.uk. 


 

1.  

What vaccine did you or your family member get today? (tick all that apply)

* required
2.  

What best describes you? (tick all that apply)

* required
3.  

How would you describe your ethnic origin?

* required
4.  

What prompted you to get vaccinated? (tick all that apply)

* required
5.  

Did you get vaccinated last year?

* required