WomanKind Survey
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1
. Have you ever heard of Womankind in Key West?
Have you ever heard of Womankind in Key West?
Yes
No
2
. Womankind is a health care center offering gynecological, primary care, mental health counseling, and
birth control services to the following people (check all that apply):
Womankind is a health care center offering gynecological, primary care, mental health counseling, and birth control services to the following people (check all that apply):
only low-income women
teenagers
all women (all income levels, race, sexual orientation)
mostly lesbians
3
. If you haven't had a physical, breast exam or pap test for over two years, what is the reason? (check all
that apply)
If you haven't had a physical, breast exam or pap test for over two years, what is the reason? (check all that apply)
No time
Nothing's wrong with me
Too expensive
Don't have a doctor or health care provider
I'm afraid they'll find something
No transportation to office
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4
. Are you a current patient of WomanKind?
Are you a current patient of WomanKind?
Yes
No
If no, why not?
5
. How easy is it to schedule appointments with your nurse practitioner?
How easy is it to schedule appointments with your nurse practitioner?
Extremely easy
Very easy
Moderately easy
Slightly easy
Not at all easy
Comment:
6
. Once you have arrived for your scheduled appointment, how long would you say your over all waiting time is (including waiting room and exam room)?
Once you have arrived for your scheduled appointment, how long would you say your over all waiting time is (including waiting room and exam room)?
0 - 15 minutes
15 - 30 minutes
30 minutes or more
Comment:
7
. How much do you trust your nurse practitioner to make medical decisions that are in your best interests?
How much do you trust your nurse practitioner to make medical decisions that are in your best interests?
A great deal
A lot
A moderate amount
A little
Not at all
Comment:
8
. How well does your nurse practitioner / staff listen to you and answer your questions?
How well does your nurse practitioner / staff listen to you and answer your questions?
Extremely well
Very well
Moderately well
Slightly well
Not at all well
Comment:
9
. How likely is it that you would recommend WomanKind to a friend or colleague?
How likely is it that you would recommend WomanKind to a friend or colleague?
Very Unlikely
Unlikely
Likely
Very Likely
Comment:
10
. How much would you be willing to pay for a 4-month program to achieve a healthy weight?
How much would you be willing to pay for a 4-month program to achieve a healthy weight?
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