The Alabama Department of Public Health, Immunization Division, is investigating an outbreak of pertussis in your community. The current outbreak spans two counties. We are conducting a survey to help identify additional individuals who may have been exposed, those who may be ill, and those who may need treatment or preventative medicine.

You have been selected to participate in this survey either because of your illness or because you are listed as having been potentially around one of the ill individuals.

The survey should take no more than 10 minutes and your answers will be extremely helpful to us. Please note, your participation is completely voluntary and all information you give will be kept confidential to the extent legally possible. You may refuse to answer any question at any time. Neither your name nor any identifying information will appear on any report.

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.