Submitted by Jeffrey Lake on Mon, 10/03/2016 - 12:29pm Do you practice in the United States? * Yes No Are you: * MD DO NP PA RN Other, please specify: Are you: Other, please specify: Are you a: * Pediatrician Adolescent medicine specialist PCP/FP/GP Other, please specify: Are you a: Other, please specify: Do you take care of patients aged 16-18 years old? * Yes No Do you take care of patients aged 19-23 years old? * Yes No Please rate your overall familiarity with current ACIP immunization recommendations: * Expert Very familiar Somewhat familiar Not very familiar Not at all familiar Please rate your overall familiarity with current ACIP recommendations for Meningitis B immunization: * Expert Very familiar Somewhat familiar Not very familiar Not at all familiar Do you know what an immunization Category A recommendation means? * Yes No Not sure Do you know what an immunization Category B recommendation means? * Yes No Not sure In which category of recommendations are Meningitis B vaccines? * Category A Category B Both Category A and B Not sure Which of the following statements best describes your current approach to Meningitis B vaccine: * I initiate the discussion about Meningitis B immunization with all individuals ages 16 to 23 I initiate the discussion about Meningitis B immunization only with those individuals ages 16 to 23 who are in boarding school or college I initiate the discussion about Meningitis B immunization only with those individuals ages 16 to 23 who are immunocompromised I do not initiate the discussion about Meningitis B immunization, but if a patient or parent brings is it up, I discuss it then Other, please specify: Which of the following statements best describes your current approach to Meningitis B vaccine: Other, please specify: If you are interested in participating in the raffle for a $100/€100 Amazon gift card, please fill out the following: First Name: Last Name: Email: Leave this field blank
