Reader Survey Template

We are conducting this reader survey to learn more about the professionals who read our publication. The results will be used to enhance the content and format.

Question Title

* 1. Are the articles in Hospital Access Management written about issues of importance and concern to you?

  Always Most of the time Some of the time Rarely Never
Please choose one
Instructions: Fill in the appropriate answers. Please write in answers to the open-ended questions in the
space provided.

Question Title

* 2. Here is a list of hospital access issues. For each item, please fill in the circle for your answer accordingly. 

  should cover it more about right should cover it less don't know/no answer
9. Staffing/recruitment needs
8. Scheduling
5. Confidentiality/HIPAA
11. Training/education
6. Customer service
4. EMTALA
2. Admissions/registration
10. Technology
7. Discharge planning
3. Billing/reimbursement

Question Title

* 3. How would you rate your overall satisfaction with your job?

Question Title

* 4. How would you describe your satisfaction with your subscription to Hospital Access Management?

Question Title

* 5. How would you rate each of the following? For each item below, please fill in your answers accordingly:

  Excellent Good Fair Poor
Article selections
Overall value
Length of newsletter
Quality of newsletter
Customer service
Quality of supplements 
Timeliness

Question Title

* 6. On average, how much time do you spend reading each issue of Hospital Access Management?

Question Title

* 7. On average, how many people read your copy of Hospital Access Management?

Question Title

* 8. On average, how many articles do you find useful in Hospital Access Management each month?

Question Title

* 9. Do you plan to renew your subscription to HAM?

Question Title

* 10. To what other publications or information sources about access management do you subscribe?

Question Title

* 11. Including this publication, which publication or information source do you find most useful, and what do you like most about the publication or source?

Question Title

* 12. What is your title? (please fill in the circle for the title that most closely reflects your position and responsibilities):

Question Title

* 13. What is the highest degree that you hold?

Question Title

* 14. Please list the top three challenges you face in your job today.

Question Title

* 15. What do you like most about HAM?

Question Title

* 16. What do you like least about HAM?

Question Title

* 17. What issues would you like to see addressed in HAM?

Question Title

* 18. How can we best reach you to follow up? (Optional)

T