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Our Gender Care IPC Team is committed to providing positive, gender affirming care experiences at Carea CHC.  Please complete this short survey and let us know how we are doing and where we can improve.

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* 1. Age:

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* 2. Gender:

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* 3. How were you referred to our program?

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* 4. Please indicate what transition related care was provided to you by our team: (Select all that apply)

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* 5. Were there any care needs that were left unmet or services you were unable to access?  Please share if so,

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* 6. Treating each client with dignity, respect, kindness, and inclusion are expectations we strive to meet for each and every interaction.  During your visits (virtual or in person) with the following team members, please share how we did in the above goals.

I was treated with dignity, respect, kindness, and inclusion when interacting with our MEDICAL SECRETARIES:

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* 7. I was treated with dignity, respect, kindness, and inclusion when I interacted with our SYSTEM NAVIGATIOR (Nic):

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* 8. I was treated with dignity, respect, kindness, and inclusion when I interacted with our NURSE PRACTITIONER (Mellanie):

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* 9. I was treated with dignity, respect, kindness, and inclusion when I interacted with our onsite NURSE:

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* 10. Is there anything during your care that stood out to you as making your care experience GREAT?  If so, please share so we can keep doing what we are doing.

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* 11. What could we do to improve the care experience?  Please share any issues, concerns or suggetions.

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