* 1. Which provider do you see most often here at Jamestown Primary Care?

* 2. Is your healthcare provider, the provider you usually see if you need a check-up, want advice about a health problem, or get sick or hurt?

* 3. How long have you been going to your healthcare provider?

* 4. In the last 12 months, how many times did you visit your healthcare provider?

* 5. In the last 12 months, did you phone your healthcare provider’s office to get an appointment for an illness, injury, or condition that needed care right away?

* 6. In the last 12 months, when you phoned your healthcare provider’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed?

* 7. In the last 12 months, did you make any appointments for a check-up or routine care with your healthcare provider?

* 8. In the last 12 months, when you made an appointment for a check-up or routine care with your healthcare provider, how often did you get an appointment as soon as you needed?

* 9. In the last 12 months, did you phone your healthcare provider’s office with a medical question during regular office hours?

* 10. In the last 12 months, when you phoned your healthcare provider’s office during regular office hours, how often did you get an answer to your medical question that same day?

* 11. In the last 12 months, did you phone your healthcare provider’s office with a medical question after regular office hours?

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