Mahalo for sharing your voice.

This survey is about your experiences during the past 12 months regarding your healthcare on Hawaiʻi Island. Your answers will help Hawaiʻi Island Community Health Center and community partners understand what is working, what is not, and what our communities need most.

Taking this survey is your choice. Your answers are private and will be combined with others to look at community needs. There are no right or wrong answers, and you may skip any question.

We estimate the survey may take 10 - 12 minutes to complete.

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1. In general, how would you rate your overall health?

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2. Has a doctor, nurse, or other health professional ever told you that you have any of the following? (check all that apply)

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3. When was your last dental visit?

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4. I have a regular doctor, clinic, or healthcare provider.

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5. I can get medical care when I need it.

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6. It is easy for me to see a medical specialist if needed.

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7. Inter-island travel is a barrier to receiving healthcare.

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8. Transportation makes it difficult to get healthcare.

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9. Cost prevents me from seeing a doctor or getting medicine.

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10. What health insurance coverage do you have? (check all that apply)

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11. My health insurance meets my healthcare needs.

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12. I am concerned about possible changes to my health insurance.

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13. I worry about running out of food before I can afford to buy more.

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14. Eating a healthy diet can prevent or improve chronic diseases such as diabetes, heart disease, or high blood pressure.

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15. I would gladly accept healthy food items from a community or health organization for myself and my family.

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16. I am comfortable asking for help from my doctor or clinic for non-medical needs such as food or housing.

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17. Healthcare providers respect my culture and beliefs.

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18. I feel respected by healthcare providers.

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19. What clinic hours would make it easier for you to get care? (check all that apply)

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20. In the past 12 months, where did you or a family member go for non-emergency care? (check all that apply)

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21. The emergency room is the place I usually go when I am sick or need health advice.

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22. I visit an emergency room for regular care (not emergencies) for the following reasons. (check all that apply)

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23. The most important services Hawaii Island should add are:

  Very Important Important Moderately important Slightly important Not important
Primary and preventive care
Dental
Vision
Specialty
Mental and emotional health
Substance use
Pediatric (keiki)
Elder (kupuna)
Women's health

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24. What are the main issues or challenges facing your family and community today?

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25. What else would you like to share with Hawaiʻi Island Community Health Center and its partners about the island's needs?

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26. On a scale of 0 to 10, how likely are you to recommend Hawaiʻi Island Community Health Center to friends or family who need care? (slide the button between 1 and 10)

0 - Not at all likely Neither unlikely nor likely 10 - Extremely likely
Clear
i We adjusted the number you entered based on the slider’s scale.

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27. What is the ZIP Code where you live most of the time?

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28. What is your age group?

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29. What is your race? (check all that apply.)

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30. Do you identify as Latino or Hispanic?

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31. What is your gender identity?

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32. What language would you prefer to use for your doctor and dentist appointments?

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33. May we contact you for follow-up or community discussions? If yes, please provide your name and contact information.

Mahalo!

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