Introduction

Share your views about the Covid-19 vaccine. Your chance to win a £150 Amazon voucher!

The NHS is North West London will soon be offering the Covid-19 vaccination to people under 50. You can help the NHS understand the needs and concerns of local people by completing this short survey.

This survey is for people aged 18-50 who live in one of the eight boroughs within North West London.

The survey should only take about 7 minutes. On completion you will have the chance to enter a prize draw for a £150 Amazon voucher.

Privacy statement
The answers you provide will be treated as confidential and all information provided will only be used for the purpose of this survey. We will not pass your information to any third party not involved in the analysis of this survey. All personal and other information that you provide will be processed in accordance with the Data Protection Act 2018 and GDPR (General Data Protection Regulations).

 
About you
We ask this question because this survey is for people that live within North West London. We also want to know that we have heard from people across the region.

Question Title

* 1. In which borough do you live?

Question Title

* 2. How old are you?

We ask this question because we want to hear from people aged 18-50. We also want to ensure we hear from a variety of people within that age range.

Question Title

* 3. What is your gender?

We ask this question to make sure we are listening to a variety of people.

Question Title

* 4. Do you consider yourself to have a disability? (For example that affects access to certain locations, or impacts travel?)

We ask this question to ensure we are including people; both with this survey and when we think about access to vaccination.

Question Title

* 5. Do you live with a long-term health condition?

We ask this question to ensure we are including people; both with this survey and when we think about access to vaccination.

Question Title

* 6. How would you describe your ethnicity?

We ask this question to ensure we are listening to a variety of people and not excluding anyone. You do not have to answer this question if you prefer not to.

Question Title

* 7. What is your religion, if you have one?

We ask this question to ensure we are listening to a variety of people and not excluding anyone. you do not have to answer this question if you prefer not to.

Question Title

* 8. Have you already been offered a Covid vaccination?

Question Title

* 9. If you have already been offered a Covid vaccination, did you take it up?

Question Title

* 10. If you did take up the Covid vaccination, please tick all that apply.

Question Title

* 11. If you did not take up the Covid vaccination, please tick all that apply.

Question Title

* 12. When you are offered the Covid-19 vaccination, do you plan to have it?

Question Title

* 13. If you do plan to have the vaccination when it is offered to you, please tick all that apply.

Question Title

* 14. If you do not plan to have the vaccination when it's offered to you, or you are not sure, please tick all that apply.

Question Title

* 15. Which of these possible vaccination sites would you prefer to visit for your vaccination? Please tick up to three locations.

Question Title

* 16. What is most important to you about being able to access your vaccination? Tick the answer that most applies.

Question Title

* 17. When it comes to making decisions about vaccinations, who do you mostly talk to or where do you mostly look for advice? Tick up to three choices.

Question Title

* 18. Is there anything else you would like to say?

Question Title

* 19. Please tell us where you saw the link to this survey

Question Title

* 20. Would you be interested in joining the North West London Citizen's Panel?

Citizen's Panel members receive surveys and information about NHS services. Members represent people from across North West London.

Question Title

* 21. Would you like to be entered into the prize draw to win a £150 Amazon voucher?

Question Title

* 22. If you answered YES to joining the citizen's panel or to being entered into the prize draw, please provide your email address below.

Please note your email address will ONLY be used for the purpose to which you have agreed. Your email address will not be connected to the other answers you have provided in this survey. Your email address will NOT be passed to any third party.

Thank you for completing our survey about Covid-19 vaccination. If you have further questions about the vaccination, visit The NHS COVID-19 Vaccination Programme :: North West London Clinical Commissioning Groups (nwlondonccgs.nhs.uk) or NHS.uk for more information.

T