Strategic Planning - Regionalization Survey

Question Title

* 1. Which services below would your facility use? (Please rank)

Question Title

* 2. Other

Question Title

* 3. Where would your facility provide these services?

Within market

Within your region (the facilities with your immediate area)

VISN-wide

Throughout VA

Question Title

* 4. How would your facility provide these services?

Face to Face

Tele-health

Provider on the Move

Other (please specify)

Question Title

* 5. Comments