We understand you are a Clinically Extremely Vulnerable shielding patient who has made the choice not to have your COVID-19 vaccination.
We would like to understand why at this point in time, you have made this choice.  All of the feedback is anonymous, and we will be using it to develop communication and information that may help inform you to have the COVID-19 vaccination.
Thank you for taking the time to share your feedback.

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* 1. Please read the statements below and tick each one that is relevant to you.

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* 2. If you are living with a long term health condition or have stated you live with a specific health condition, please let us know what it is. This will help us to develop information with patient groups and national charities who may be supporting you.

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* 3. If you have not declined the COVID-19 vaccination and you are interested in receiving it, please share your contact details below:

If you would like to speak to someone about your COVID-19 experience or would like further information to help you make the choice to have the COVID-19 vaccination, please email mhcc. engagement@nhs.net or call 0161 213 1756.

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* 4. Please share any other feedback with us here. 

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