Childhood diseases

Please answer yes or no on the following questions.

Name


  1. Have you had the measles?
    Yes
    No


  1. Have you had chicken pox?
    Yes
    No


  1. Have you had the Mumps?
    Yes
    No


  1. Have you ever had the flu?
    Yes
    No


  1. Have you ever had pneumonia?
    Yes
    No


  1. Do you know anyone that has Hepatitis?
    Yes
    No


  1. Have you had a flu shot, this year?
    Yes
    No