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Hereford Regional Medical Center CHNA Survey

Hereford Regional Medical Center is conducting a Community Health Needs Assessment in partnership with the Texas Rural Health Association to better understand the most important health-related issues for community residents. The information collected will help the hospital improve its patient and community services.
Please take about 10 minutes to complete this survey. Your responses will be private. Taking this survey will not affect any services that you receive.
Results from this survey that are shared with the community will be combined across all respondents. It will not be possible to identify you or your responses. Thank you for completing this survey.
1.How old are you?
2.What is the highest level of education you have completed or the highest degree you have received?
3.What is your gender?
4.Which of the following categories best describes your employment status?
5.What is your ZIP code?(Required.)
6.What is your race or ethnicity?
7.Which of the following ranges represent your total annual household income last year?
8.In the past 12 months, have you had trouble paying for any of the following? Check all that apply.
9.Considering "on-site" services Hereford Regional Medical Center is able to provide, what is the most important to you? Check all that apply.
10.What services would you like to see implemented at Hereford Regional Medical Center? Check all that apply.
11.How did you find the experience of booking appointments for Hereford Regional Medical Center?
12.Was our staff empathetic to your needs?
13.How long did you have to wait until until you were seen by a member of our staff?
14.Were you satisfied with the staff person who treated you?
15.How easy is it to navigate the facilities within the Medical Center?
16.How satisfied are you with the treatment plans our providers prescribed for you?
17.Was the staff able to answer all of your questions?
18.Residents in the area are able to access a primary care provider when needed (family doctor, general practitioner etc.)
19.Residents in the area are able to access a medical specialist when needed (cardiologist, dermatologist, neurologist etc.)
20.Residents in the area are able to access a dentist when needed.
21.There are a sufficient number of bilingual providers in the area.
22.There are a sufficient number of mental health providers in the area.
23.Transportation for medical appointments is available to area residents when needed.
24.What are the most significant barriers that keep people in the community from accessing healthcare when they need it? Choose your top 3 answers.(Required.)
25.Are there specific populations in this community that you think are not adequately served?
26.If you answered YES to the previous question, please identify which populations you think
are most underserved?
27.Related to health and quality of life, what resources or services do you think are missing in
the community? Check all that apply.
28.In your opinion, what is being done well in the community in terms of health and quality of
life? Check all that apply.
29.What challenges do people in the community face in trying to maintain healthy lifestyles
like exercising, eating healthy, managing chronic conditions? Check all that apply.
30.Using any number from 0 to 10, where 0 is the worst district possible and 10 is the best
district possible, what number would you use to rate Hereford Regional Medical Center.
31.Using any number 0 to 10, with 0 being the worst and 10 the best, please rate the
cleanliness and ambiance of Hereford Regional Medical Center.
32.What could be added to Hereford Regional Medical Center to improve your experience? Check all that apply.
33.If health education topics were made available free of charge for the community, what topics would you be interested in? Check all that apply.
34.How would you like to receive updates about Hereford Regional Medical Center? Please choose two options.(Required.)
35.Would you recommend this hospital district to your friends and family?
36.Do you have suggestions for ways we could improve?
37.Please share any additional comments you have below: