One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations

Self-Assessment Tool Feedback Questionnaire

Instructions for completing the questionnaire:
The questions below refer to the self-assessment tool provided in Chapter 8 of One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations. Your participation is completely voluntary, but we hope that you will help us by answering these questions. Please check the box next to the answer that is most appropriate.

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1. How did your organization use the self-assessment tool?

2. Who was involved in your organization’s self-assessment? (Check all that apply)

3. Overall, how useful do you feel the self-assessment tool is?

4. What type of organization are you from?

5. Where is your organization located? (Select state from dropdown)

6. Comments and suggestions for improvement: