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Hepatitis A, B, and C Prevention Programs
Information and Programs for People at Risk

Presented by the Immunization Action Coalition with dedicated funding from the
Division of Viral Hepatitis at the Centers for Disease Control and Prevention

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What do you think of this site?

Please complete this short survey. We will not release or publish any personal data.

Note that one of the "Contact me" options must be selected.

1.	How did you find out about this website?
		Received the web address via the IAC Express listserv
		Received the web address from a friend or colleague
		Used a hyperlink from IAC’s parent website, www.immunize.org
		Used a hyperlink from another website
		Found the web address in a newsletter or in other printed material
		Used a search engine
		Other, please specify:

2.	Please provide your opinion of this website:
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	Organization:	Excellent	Good	Fair	Poor
	Usefulness:	Excellent	Good	Fair	Poor


3.	Did this website provide the information you expected?
		Yes.
		No, I was looking for information about hepatitis, not programs working to prevent hepatitis.
		No. Reason:

4.	Did you access any of the materials listed under "Background Information"?
		Yes
		No

5.	Are you planning to contact any of the programs listed for more information?
		Yes.
		No, I found the information I needed.
		No, none of the programs had information pertinent to my situation.
		No, I am not involved in developing or managing a hepatitis prevention program.
		No, I was just surfing the Internet.

6.	Did you download any of the "Information for Clients" offered at the end of each section?
		Yes
		No

7.	Have you ever visited the Coalition’s parent website at www.immunize.org?
		Yes
		No

8.	What is your primary occupation?
		Administrator
		Researcher or scientist
		Physician
		Nurse
		Other health care provider
		Educator
		Student
		My occupation is not related to my interest in this topic
		Other, please specify:

9.	Where do you work?
		Federal, state, or local government administration
		Public sector health care
		Private sector health care
		Scientific research
		Education
		My employment is not related to my interest in this topic
		Other, please specify:

10.	Do you work with individuals at risk for hepatitis A, B or C?
		Yes
		No

11.	If yes, what populations do you serve? (Check all that apply)
		Men who have sex with men
		Clients of STD/HIV clinics
		Clients of family planning clinics
		Injecting drug users
		Incarcerated juveniles
		Incarcerated adults
		Sex workers
		Hemodialysis patients
		Persons with higher-than-average rates of hepatitis B infection due to ethnicity or country of origin
		Health care workers
		International travelers
		Other, please specify:

12.	Has this website helped you in any way?
	Please include any comments or suggestions you may have.

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Thank you for your time!

Immunization Action Coalition
www.immunize.org
admin@immunize.org

Hepatitis Prevention Programs
www.hepprograms.org
admin@hepprograms.org

1573 Selby Ave, Ste 234 St Paul, MN 55104 Tel (651) 647-9009 Fax (651) 647-9131