Student Health Advisory Committee Survey

1. Graduation Year

Graduation Year 2013

2014

2015

2016

Please give email address if you wish to be entered for prize/raffle.

2. How often do you use the Health Services per year?

How often do you use the Health Services per year? Over 10 Times

7-10

4-6

1-3

Never

Explain why?

3. Please rate services you have used?

	Poor	Fair	Good	Very Good	Excellent
Appointment/Check in Service	*Please rate services you have used? Appointment/Check in Service Poor	Appointment/Check in Service Fair	Appointment/Check in Service Good	Appointment/Check in Service Very Good	Appointment/Check in Service Excellent
Women's Health Service	Women's Health Service Poor	Women's Health Service Fair	Women's Health Service Good	Women's Health Service Very Good	Women's Health Service Excellent
On-Line Insurance Waiver Process	On-Line Insurance Waiver Process Poor	On-Line Insurance Waiver Process Fair	On-Line Insurance Waiver Process Good	On-Line Insurance Waiver Process Very Good	On-Line Insurance Waiver Process Excellent
College Insurance Plan - BCS	College Insurance Plan - BCS Poor	College Insurance Plan - BCS Fair	College Insurance Plan - BCS Good	College Insurance Plan - BCS Very Good	College Insurance Plan - BCS Excellent
Insurance Billing Service	Insurance Billing Service Poor	Insurance Billing Service Fair	Insurance Billing Service Good	Insurance Billing Service Very Good	Insurance Billing Service Excellent
Substance Abuse Educator	Substance Abuse Educator Poor	Substance Abuse Educator Fair	Substance Abuse Educator Good	Substance Abuse Educator Very Good	Substance Abuse Educator Excellent
Massage Therapist	Massage Therapist Poor	Massage Therapist Fair	Massage Therapist Good	Massage Therapist Very Good	Massage Therapist Excellent
Orthopedic/Sports Medicine	Orthopedic/Sports Medicine Poor	Orthopedic/Sports Medicine Fair	Orthopedic/Sports Medicine Good	Orthopedic/Sports Medicine Very Good	Orthopedic/Sports Medicine Excellent
Registered Dietitian	Registered Dietitian Poor	Registered Dietitian Fair	Registered Dietitian Good	Registered Dietitian Very Good	Registered Dietitian Excellent
College Physician	College Physician Poor	College Physician Fair	College Physician Good	College Physician Very Good	College Physician Excellent
Nurse walk-in clinic	Nurse walk-in clinic Poor	Nurse walk-in clinic Fair	Nurse walk-in clinic Good	Nurse walk-in clinic Very Good	Nurse walk-in clinic Excellent
Allergy clinic	Allergy clinic Poor	Allergy clinic Fair	Allergy clinic Good	Allergy clinic Very Good	Allergy clinic Excellent
Nurse Practitioner	Nurse Practitioner Poor	Nurse Practitioner Fair	Nurse Practitioner Good	Nurse Practitioner Very Good	Nurse Practitioner Excellent
Travel Clinic	Travel Clinic Poor	Travel Clinic Fair	Travel Clinic Good	Travel Clinic Very Good	Travel Clinic Excellent
Cold/Flu Self Care Clinic	Cold/Flu Self Care Clinic Poor	Cold/Flu Self Care Clinic Fair	Cold/Flu Self Care Clinic Good	Cold/Flu Self Care Clinic Very Good	Cold/Flu Self Care Clinic Excellent
EZPZ (STI) self drop off service	EZPZ (STI) self drop off service Poor	EZPZ (STI) self drop off service Fair	EZPZ (STI) self drop off service Good	EZPZ (STI) self drop off service Very Good	EZPZ (STI) self drop off service Excellent

4. Please check all services used at the Health Center.

Please check all services used at the Health Center. Tested for STD

Tested for HIV

Tested for pregnancy

Emergency contraception (Plan B)

Routine contraception

Condoms

General Medicine

General Women's Health

Cold /flu Clinic

Insurance billing question/concern

Allergy Clinic

Travel Clinic

Sports Medicine Clinic

Counseling session with the Substance Abuse Educator

Nutritional Counseling

Attended Student Health Services Fair

Other Service (please specify)

5. Please check all vaccines or services you have received at the Health Services this year.

Please check all vaccines or services you have received at the Health Services this year. Seasonal Flu Vaccine

Hepatitis A

Hepatitis B

Allergy Injections

Varicella (chicken pox)

Typhoid

Tetanus

Meningitis (Menactra)

HPV(Gardasil)

Polio

Japanese Encephalitis

Rabies

Measles, Mumps, Rubella (MMR)

PPD-TB Testing

6. Have you used your health insurance for billing at the Health Center?

Have you used your health insurance for billing at the Health Center? Yes

If no please comment why?

7. Preference on how to pay Health Services bill

Preference on how to pay Health Services bill Use personal insurance with ease

Use personal insurance but had problems

Insurance not taken at Health Center

Bill to student account only

Bill to parent

Prefer to pay bill with cash/check

Prefer to pay by credit card/debit card

Prefer to pay by college onecard (debit card)

Other (please specify)

8. Please check all that would be of interest to you in Wellness Promotion Programming.

Please check all that would be of interest to you in Wellness Promotion Programming. Improvement of Study Habits

Stress Reduction and Management

Healthy Sleep habits

Prevention of Sexual Assault

Nutrition

Management of Obsessive Compulsive Disorders

Effect of of Alcohol Use and Abuse on College Students

Prevention of STIs

Living with Mental Health Issues such as depression, anxiety

Eating Disorders

How to manage college life with ADHD

Quit Smoking

Abuse of prescription medication

Street drugs effect on body

Birth Control Methods

Travel Health

How to start an exercise program

Weight loss/Weight gain program

How to stay healthy at college

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1. Haverford College Morris Health Services

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1. Haverford College Morris Health Services

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