Focus Group Interest Form

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Join us in a virtual focus group to share your views and opinions about COVID-19 vaccine delivery in Black and Latinx communities in South Los Angeles. Focus groups will include 8-10 participants. Participants will receive a $50 Visa electronic gift card for 1.5 hours of participation.

Please note: This discussion is focused in South Los Angeles and participants should either live or provide services within South Los Angeles.

Focus groups include:
• 1 Community Leadership focus groups - CLOSED
• 1 Community focus group (English): Monday, July 26, 2021 5pm-6:30pm - CLOSED
• 1 Community focus group (Spanish): Monday, August 2, 2021 5pm-6:30pm - CLOSED
• 1 Provider focus group: Tuesday, August 24, 2021 1pm-2:30pm - OPEN

Please contact the Principal Investigators of the study team, Dr. Dilara Uskup and Dr. Steve Shoptaw by email at duskup@ucla.edu with any questions.

Email *

Do you reside or work within South Los Angeles? *

Yes

No (Thank you for your interest but we are seeking participants within the South Los Angeles communities)

Name *

Phone number *

Preferred method of contact *

Phone

Both email and phone

Which category best describes you? *

Community member (e.g an individual within the community unaffiliated with an organization)

Community essential Worker (e.g. Grocery store, Department Store Employee, teacher, construction worker))

Clinical Provider (e.g. Doctor/Nurse/PA)

Required

What is the best time to contact you? *

Morning

Afternoon

Evening

Required

Send me a copy of my responses.

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