Vaccine Tier Screening Tool

Quiz Questions

• 1.
  Welcome to Flathead City-County Health Department COVID-19 Vaccine Tier Screening. This Screening Tool is offered for informational purposes to help you determine which COVID-19 vaccine tier you belong in as outlined by the Montana COVID-19 Vaccine Distribution Plan. The guidance you receive depends on the accuracy of the information you provide as well as current guidelines for the tiered system. Based on your self-reported answers, the tool will provide additional information and next steps for each vaccination tier. This tool does not provide appointment scheduling, and the information you provide in this survey is not collected.  By clicking “I AGREE” below, you indicate that you have reviewed and agree to the above disclaimer.

  • A.
    I agree to the above disclaimer.
  • B.
    I do not agree to the above disclaimer.
• 2.
  Tier 1A Screening: Are you a frontline healthcare worker, a healthcare worker with direct patient contact or virus exposure, or a resident or staff of a long term care or assisted living facility?

  • A.
    I am a frontline healthcare worker.
  • B.
    I am a healthcare worker with direct patient contact or virus exposure.
  • C.
    I am a resident or staff of a long term care or assisted living facility.
  • D.
    I am none of the above.
• 3.
  Tier 1B/Tier 1B+ Screening: Are you aged 70 years or older, or are you American Indian or a person of color?

  • A.
    I am aged 60 years or older.
  • B.
    I am American Indian or another person of color.
  • C.
    I am none of the above.
• 4.
  Tier 1B/Tier 1B+ Screening: Do you have any of the following high risk health conditions: cancer, chronic kidney disease, COPD, down syndrome, heart conditions such as heart failure, coronary artery disease, or cardiomyopathies, immunocompromised state from solid organ transplant, severe obesity, sickle cell disease, type 1 or type 2 diabetes mellitus, asthma, cerebrovascular disease, cystic fibrosis, immunocompromised state, neurologic conditions, liver disease, pulmonary fibrosis, thalassemia.

  • A.
    Yes, I have one of the conditions listed above.
  • B.
    No, I do not have one of the conditions listed above.
• 5.
  Tier 1C Screening: Are you a frontline essential worker or do you reside in a congregate or correctional facility?

  • A.
    I am a frontline essential worker.
  • B.
    I reside in a congregate or correctional facility.
  • C.
    I am none of the above.

Quiz Outcomes

• 1.
  You are in Tier 2 

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  Based on the answers you submitted in the screening, you belong in:Tier 2 of the Montana COVID-19 Vaccine Distribution Plan. Flathead County is not currently vaccinating Tier 2 individuals. Please continue to check our website at https://www.flatheadhealth.org/covid-19-vaccine/ for updates on when vaccinations will begin in your Tier.
• 2.
  You are in Tier 1C

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  Based on the answers you submitted in the screening, you belong in:Tier 1C of the Montana COVID-19 Vaccine Distribution Plan. Tier1C includes frontline essential workers and individuals residing in congregate care and correctional facilities.Flathead County is not currently vaccinating Tier 1C individuals. Please continue to check our website at https://www.flatheadhealth.org/covid-19-vaccine/ for updates on when vaccinations will begin in your Tier.
• 3.
  You are in Tier 1B or Tier 1B+

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  Based on the answers you submitted in the screening, you belong in:Tier 1B or Tier 1B+ of the Montana COVID-19 Vaccine Distribution Plan. Tier1B/Tier 1B+ includes individuals aged 60 years or older, American Indians or other people of color, and individuals with medical conditions that may put them at higher risk of developing serious complications from COVID-19. Please visit our website and submit an online vaccine request form to be put on the list to receive the COVID-19 vaccine. Vaccine supply is still limited and the number of appointments available each week varies. An FCCHD staff member will follow up with you to schedule an appointment when a vaccine becomes available. Please note that depending on vaccine supply it could take several weeks before we are able to schedule you.
• 4.
  You are in Tier 1A  

  Image Source

  Based on the answers you submitted in the screening, you belong in:Tier 1A of the Montana COVID-19 Vaccine Distribution Plan. Tier1A includes frontline healthcare workers, healthcare workers with direct patient exposure, and staff and residents of long term care or assisted living facilities. Flathead County is currently vaccinating Tier 1A individuals. If you are a healthcare worker and have not already received your vaccine, please call 406-751-8119 to schedule a vaccine appointment. The vaccination of staff and residents of long term care and assisted living facilities is a service provided nationally by CVS or Walgreens. If you belong to this group and have not yet received your vaccine please follow up with your organization supervisor for more information.
• 5.
  Notice: You did not agree to the disclaimer.

  You must agree to the disclaimer at the beginning of the survey for the survey tool to work correctly. Thank you for your understanding.