You have completed 0% of this survey 0% default Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters. Survey 2022 (This question is mandatory) Email Please check the format of your answer. (This question is mandatory) Name (This question is mandatory) Age Please check the format of your answer. (This question is mandatory) City (This question is mandatory) Your latest vaccine shot Please choose... First shot Second shot Booster 1 Booster 2 (This question is mandatory) Vaccine Type Pfizer Moderna J&J Other: (This question is mandatory) Side Effects Experienced (This question is mandatory) Are you interested in seeking legal remedies? Yes No (This question is mandatory) Are you interested in connecting with a health care professional for treating your side effects? Yes No (This question is mandatory) Did you take the vaccine only due to employment or school related requirements? Yes No (This question is mandatory) How did you hear about us? Billboard Social Media Word of Mouth Submit Load unfinished survey Resume later Please confirm you want to clear your response? Exit and clear survey ×