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. 

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

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* 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.

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* 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
Immunization and infectious diseases (COVID included)
Access to health care services
Family planning
Tobacco use
Infant and child health
Oral health / dental care
Dementia / Alzheimer's Disease
Nutrition, physical activity, and weight
Injury and violence
Kidney disease
Hearing and vision conditions
Diabetes
Substance abuse
Cancer
Arthritis / Osteoporosis / Back conditions
Sexually transmitted diseases
Heart disease and stroke
Respiratory diseases
HIV/AIDS
Mental Health

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

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

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

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

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

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* 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.

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* 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.

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* 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.

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

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

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

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

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* 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.

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

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

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

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

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* 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
 

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