My Child is NOT up-to-dte with his/her shots because: Check All That Apply

of my inability to pay $10.00 administration fee

my insurance does not cover immunizations

clinic hours coincide with my work schedule.

I cannot make an appointment that is so far in advance.

there is not a clinic convenient to me.

I have no transportation.

I don't think it is necessary until my child goes to school.

my doctor/provider does not remind me when I am at his/her office.

I don't remember.

of my religious beliefs.

I feel the risk from vaccines is greater than the risk of disease.

medical reasons

Other: Please Specify