Ngati Kahu Iwi Survey

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* 1. Where do you live?

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* 2. What type of internet access do you have at home?

Broadband

Dial-up

Only have access to the internet on my cell phone

Do not have access to the internet

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* 3. How far away is your nearest GP Medical clinic?

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* 4. Is there an Urgent after hours Medical Clinic near by?

Yes

No

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* 5. What is the name of closest hospital to where you live?

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* 6. In the last 12mths how many times have you visited an urgent after hours/or an Emergency Department for care?

0 Times

1-5 Times

6-10 Times

10+ Times

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* 7. If we set up a free 6 week trial for Ngati Kahu members would you register?

Yes

No

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* 8. Do you think you would use www.emergencyconsult.co.nz during this 6 week free trial period?

Yes

No

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* 9. Do you have access to a pharmacy/Chemist nearby?

Yes

No

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* 10. Do you have access to a nurse clinic?

Yes

No

Other (please specify)