Screen Reader Mode Icon
Thank you for taking the time to share your input on community health needs. Your submissions are confidential. Only our consultants (Eide Bailly) see individual responses and then share summarized information with us. 

Question Title

* 1. I live and/or work in Highland County, Bath County, Alleghany County, or Covington.

Question Title

* 2. How would you rate the general health of people in your community? Community is defined as the three-county region (Bath, Highland, Alleghany) and includes Covington.

Question Title

* 3. Please rate each of these as one of the following: 
  • Major problem in the community
  • Moderate problem
  • Minor problem
  • Not a problem at all
  • N/A (not applicable)

  Major problem Moderate problem Minor problem Not a problem at all N/A
Diabetes
Nutrition, physical activity, and weight
Cancer
Family planning
Sexually transmitted diseases
HIV/AIDS
Hearing and vision conditions
Access to health care services
Oral health / dental care
Dementia / Alzheimer's Disease
Immunization and infectious diseases (COVID included)
Arthritis / Osteoporosis / Back conditions
Kidney disease
Injury and violence
Tobacco use
Infant and child health
Heart disease and stroke
Mental Health
Respiratory diseases
Substance abuse

Question Title

* 4. The following services are available at Bath Community Hospital. Please rate the overall quality for each service. If you haven't used a service and don't know how to rate it,  please answer N/A. 
  • Excellent
  • Good
  • Fair
  • Poor
  • N/A (not applicable)

  Excellent Good Fair Poor N/A
Respite Care
Swing bed rehabilitation
Surgery
Outpatient rehabilitation (physical therapy, occupational therapy, speech therapy)
Emergency department
Ambulatory nurse clinic (wound care, IV infusion, injection, etc.)
Behavioral health services
Wellness Center
Bath Community Physicians Group
Pharmacy
Diagnostic services (X-ray, CT, MRI, lab, mammography, etc.)

Question Title

* 5. How would you rate your knowledge of the health services (listed in previous question) that are available at Bath Community Hospital?

Question Title

* 6. Please select what you feel are the three (3) most important factors for a health community

Question Title

* 7. Overall, how would you rate your physical health?

Question Title

* 8. Overall, how would you rate your mental health?

Question Title

* 9. Preventative testing and services help to prolong lifespan and can lead to early detection of serious health problems. Which of the following services have you used in the past year? Select all that apply.

Question Title

* 10. Thinking about the hospital you use most frequently, what are the three (3) most important reasons for selecting that hospital? Select three that apply.

Question Title

* 11. If you have seen a primary health care provider (family physician, physician assistant or nurse practitioner) for health care services, where was that primary health care provider located? Please select only one.

Question Title

* 12. Why did you select that particular primary care provider? Select ALL that apply.

Question Title

* 13. If you routinely seek primary health care at a provider other than Bath Community Hospital (and clinics), why? Select ALL that apply.

Question Title

* 14. In the last year, was there a time you needed mental health counseling but could not get it? 

Question Title

* 15. If you answered "yes" to the previous question, why weren't you able to get mental health counseling? Please select ALL that apply.

Question Title

* 16. Thinking about the mental health counseling services you use most frequently, what are the three (3) most important reasons for selecting that mental health provider? Select three (3) that apply.

Question Title

* 17. In your opinion, what would improve your community's access to health care? Please select ALL that apply.

Question Title

* 18. How can Bath Community Hospital better meet your healthcare needs?

Question Title

* 19. Please check "yes" if you are aware of this BCH service. Please check "no" if you are not aware of it.

  Yes No
Outpatient rehabilitation (physical therapy, occupational therapy, speech therapy)
Emergency department
Diagnostic services (X-ray, CT, MRI, lab, mammography, etc.)
Respite Care
Bath Community Physicians Group
Wellness Center
Surgery
Behavioral health services
Ambulatory nurse clinic (wound care, IV infusion, injection, etc.)
Swing bed rehabilitation
Pharmacy

Question Title

* 20. What would be your preferred method of receiving notifications for needed preventative clinic visits and/or screenings? Select as many as you prefer. 

0 of 20 answered
 

T