Sign in to Google to save your progress. Learn more
Informed Consent

Whatcom County Health and Community Services, its managers and staff, and the Divisions comprising our organization are committed to asking for, listening to, and utilizing the feedback and insights of our customers and stakeholders. This immunizations project is investigating the current access to, utilization of, and support for immunizations in Whatcom County. The purpose of this survey is to learn about current utilization of vaccine services in Whatcom County and barriers to their access. The information collected will be used to inform future Whatcom County Health and Community Services immunizations project planning and service delivery.

I Understand That:

The survey is voluntary, and I may discontinue participation at any time. Unless you choose to provide contact information or identify yourself in the comments, all responses are anonymous and cannot be linked back to you. No one will be able to identify you when the results are reported. Your participation and your responses to the survey will not affect any Whatcom County Health and Community Services programs or benefits to which you are entitled. The information you provide may be used to inform future public health planning. Thank you for taking the time to complete this 10 minute survey. Please take this survey only once per person. 

If you have questions about the content of the survey, please contact Alexus Kim at akim@co.whatcom.wa.us  or 360-603-1602. If you have any questions about the security or use of the information you provide, please contact the WCHCS Health Information and Assessment Supervisor, Amy Hockenberry, at ahockenb@co.whatcom.wa.us.

Do you consent to move forward with this survey, based on what you have read above?
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy