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* 1. Do you currently use Sacopee Valley Health Center?

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* 2. How many years have you been a patient of the Health Center

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* 3. What is your current age range? 

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* 4. Are there other services that you feel would be beneficial to our patients or the community, such as family counseling, group visits to address health issues such as diabetes, patient education, other educational forums such as estate planning, financial planning, etc.

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* 5. Which of the Health Center's services do you currently use?  Check all that apply.

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* 6. Does the Health Center hours of operation meet your needs?

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* 7. Are there services that you feel the Health Center needs to expand on?

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* 8. Did you know that the Health Center offers Medication Assisted Treatment and counseling for Substance Use Disorder patients?

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* 9. What other services could we provide to support the communities and the families affected by Substance Use Disorder?  Such as family counseling, etc?

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* 10. Please rate the importance of how you connect with the Health Center

  Very Important Somewhat Important Not Important
Website
Print Advertising including the Shopping Guide
Phone calls
Automated calls and reminders

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* 11. Do you visit the Health Center's Facebook Page?

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* 12. On a scale of 1-5, with 5 being excellent, how easy is it to get the information you need by calling the Health Center?

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 13. On a scale of 1-5, would it interest you to be able to contact the Health Center by email or online through a patient portal?

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 14. On a scale of 1-5, how easy is it to get an appointment at the Health Center?

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 15. Have you ever confused the Health Center with other facilities that use the name "Sacopee Valley" such as our Dental and Optometry departments.

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* 16. Have you ever been denied care at the Health Center based on the following?

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* 17. Have you been to the hospital or emergency room in the last year?  If so, how easy was it to get a follow-up appointment at the Health Center?  Scale of 1-5 with 5 being easy to get an appointment.

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 18. On a scale of 1-5, compared to other healthcare providers, how do you rate our Health Center?

  Excellent Better Could Be Better Worse
Providing additional services such as dental, optometry, mental health
Affordable Care
Quality of Care
Easy Access to Services
Supporting Community Health and Wellness into the Community

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* 19. How would you rate your overall health?

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* 20. How would you rate your overall mental health?

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* 21. On a scale of 1-5, how important is it to you to be up-to-date with your health screenings, immunizations, routine care and other preventative health measures?

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 22. On a scale of 1-5, how important is it that your medical providers work as a team to coordinate your care?

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 23. In the past month, how often have you exercised or participated in a fitness activity that is not part of your normal day activities?

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* 24. On a scale of 1-5, how easy is it for you to access local fitness programs, facilities, and/or outdoor recreational areas?

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 25. How important is it to you for the Health Center to provide fitness and wellness programs?

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* 26. What are some of the positive aspects you have seen at the Health Center?

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* 27. What are some of the negative aspects you have seen at the Health Center?

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* 28. On a scale of 1-5, do you feel the Health Center's current services are a good fit for the community?

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 29. On a scale of 1-5, how valuable is the Health Center to the community?

1 5
i We adjusted the number you entered based on the slider’s scale.

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* 30. On a scale of 1-5, do you feel the Health Center is part of the community?

1 5
i We adjusted the number you entered based on the slider’s scale.

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