Questions about healhtcare services for veterans

This survey is for healthcare providers that are members of health networks. We are collecting data for the Department of Veterans Affairs - Office of Rural Health. The data will be analyzed and presented at the National Cooperative of Health Networks (NCHN) Leadership Summit on October 2, 2013 in Austin, TX.



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* 1. Do you or your staff ask your patients if they are Veterans?

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* 2. If not, do you know if your clinic serves any Veterans?

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* 3. How many Veterans would you say your clinic serves annually? (if unsure, your best guess is ok)

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* 4. If your answer to Q3 is more than zero:
Do you know if the Veterans you see in your clinic also use the VA for some of their health care?

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* 5. If you answered yes to Q4:
Has care coordination between your clinic and the VA ever been an issue?

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* 6. Does your clinic or network exchange patient health care information with any VA facilities?

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* 7. If yes to Q6:
Do you exchange information electronically through Health Information Exchange (HIE), or do you use fax/mail/hand carry to do so?

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* 8. How do you rate your knowledge of VA eligibility requirements for Veterans to receive health care from the VA?

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* 9. Are you willing to refer Veteran patients to the VA for health care?

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* 10. Would you say you/your providers are confident in their ability to screen Veterans for Traumatic Brain Injuries?

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* 11. Would you say you/your providers are confident in their ability to treat Veterans for Traumatic Brain Injuries?

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* 12. Please provide any additional comments about working with rural veterans that you would like to share:

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* 13. What type of healthcare provider are you? (e.g., CAH, RHC, Physician Office/Clinic; FQHC, Public Health Department, etc.)

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* 14. What state are you located in?

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* 15. For the person completing the survey, what is your title/position?

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* 16. If you would like a copy of the final report of this survey, please provide your name and email address.

Thank you for completing the survey!

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