• Sickle Cell Anemia
• Depression
• Alcohol or substance use disorder
• Intravenous drug use
• Other mental health disorder
• Other chronic condition
• Date of Health Status Collection
• How tall are you without shoes? Please choose the units you would like to use for height
• Feet
• Inches
• Meters
• Centimeters
• Please choose the units you would like to use for weight
• How much do you weigh without clothes or shoes? If you are currently pregnant, how much did you weigh before your pregnancy?
• How much do you weigh without clothes or shoes? If you are currently pregnant, how much did you weigh before your pregnancy?
• Would you say your health in general is excellent, very good, good, fair, or poor?
• Do you have a disability that interferes with your ability to carry out daily activities? Examples of daily activities include walking, climbing stairs, shopping, balancing a checkbook, bathing or dressing.
• Date of Vaccine Acceptance Collection
• Have you ever received a flu vaccination?
• Have you received a flu vaccine this season (last 6 months)?