MyChart Patient Pre-Engagement Survey

Question Title

* 1. How do you hope MyChart will improve your healthcare experience?

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
Improve communication between me and my care providers including doctors, nurses and other healthcare professionals	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Neither agree nor disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Agree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly agree
Easily share information with my family members and friends	Easily share information with my family members and friends Strongly disagree	Easily share information with my family members and friends Disagree	Easily share information with my family members and friends Neither agree nor disagree	Easily share information with my family members and friends Agree	Easily share information with my family members and friends Strongly agree
Access to my medical and personal health information anytime and anywhere	Access to my medical and personal health information anytime and anywhere Strongly disagree	Access to my medical and personal health information anytime and anywhere Disagree	Access to my medical and personal health information anytime and anywhere Neither agree nor disagree	Access to my medical and personal health information anytime and anywhere Agree	Access to my medical and personal health information anytime and anywhere Strongly agree
Allow me to better manage my appointments and set reminders	Allow me to better manage my appointments and set reminders Strongly disagree	Allow me to better manage my appointments and set reminders Disagree	Allow me to better manage my appointments and set reminders Neither agree nor disagree	Allow me to better manage my appointments and set reminders Agree	Allow me to better manage my appointments and set reminders Strongly agree
Increase my knowledge about my health condition and how to manage it	Increase my knowledge about my health condition and how to manage it Strongly disagree	Increase my knowledge about my health condition and how to manage it Disagree	Increase my knowledge about my health condition and how to manage it Neither agree nor disagree	Increase my knowledge about my health condition and how to manage it Agree	Increase my knowledge about my health condition and how to manage it Strongly agree

Other (please specify)

Question Title

* 2. How do you hope MyChart will improve your healthcare experience?

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
Improve communication between me and my care providers including doctors, nurses and other healthcare professionals	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Neither agree nor disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Agree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly agree
Easily share information with my family members and friends	Easily share information with my family members and friends Strongly disagree	Easily share information with my family members and friends Disagree	Easily share information with my family members and friends Neither agree nor disagree	Easily share information with my family members and friends Agree	Easily share information with my family members and friends Strongly agree
Access to my medical and personal health information anytime and anywhere	Access to my medical and personal health information anytime and anywhere Strongly disagree	Access to my medical and personal health information anytime and anywhere Disagree	Access to my medical and personal health information anytime and anywhere Neither agree nor disagree	Access to my medical and personal health information anytime and anywhere Agree	Access to my medical and personal health information anytime and anywhere Strongly agree
Allow me to better manage my appointments and set reminders	Allow me to better manage my appointments and set reminders Strongly disagree	Allow me to better manage my appointments and set reminders Disagree	Allow me to better manage my appointments and set reminders Neither agree nor disagree	Allow me to better manage my appointments and set reminders Agree	Allow me to better manage my appointments and set reminders Strongly agree
Increase my knowledge about my health condition and how to manage it	Increase my knowledge about my health condition and how to manage it Strongly disagree	Increase my knowledge about my health condition and how to manage it Disagree	Increase my knowledge about my health condition and how to manage it Neither agree nor disagree	Increase my knowledge about my health condition and how to manage it Agree	Increase my knowledge about my health condition and how to manage it Strongly agree

Other (please specify)

Question Title

* 3. How do you hope MyChart will improve your healthcare experience?

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
Improve communication between me and my care providers including doctors, nurses and other healthcare professionals	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Neither agree nor disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Agree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly agree
Easily share information with my family members and friends	Easily share information with my family members and friends Strongly disagree	Easily share information with my family members and friends Disagree	Easily share information with my family members and friends Neither agree nor disagree	Easily share information with my family members and friends Agree	Easily share information with my family members and friends Strongly agree
Access to my medical and personal health information anytime and anywhere	Access to my medical and personal health information anytime and anywhere Strongly disagree	Access to my medical and personal health information anytime and anywhere Disagree	Access to my medical and personal health information anytime and anywhere Neither agree nor disagree	Access to my medical and personal health information anytime and anywhere Agree	Access to my medical and personal health information anytime and anywhere Strongly agree
Allow me to better manage my appointments and set reminders	Allow me to better manage my appointments and set reminders Strongly disagree	Allow me to better manage my appointments and set reminders Disagree	Allow me to better manage my appointments and set reminders Neither agree nor disagree	Allow me to better manage my appointments and set reminders Agree	Allow me to better manage my appointments and set reminders Strongly agree
Increase my knowledge about my health condition and how to manage it	Increase my knowledge about my health condition and how to manage it Strongly disagree	Increase my knowledge about my health condition and how to manage it Disagree	Increase my knowledge about my health condition and how to manage it Neither agree nor disagree	Increase my knowledge about my health condition and how to manage it Agree	Increase my knowledge about my health condition and how to manage it Strongly agree

Other (please specify)

Question Title

* 4. How do you hope MyChart will improve your healthcare experience?

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
Improve communication between me and my care providers including doctors, nurses and other healthcare professionals	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Neither agree nor disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Agree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly agree
Easily share information with my family members and friends	Easily share information with my family members and friends Strongly disagree	Easily share information with my family members and friends Disagree	Easily share information with my family members and friends Neither agree nor disagree	Easily share information with my family members and friends Agree	Easily share information with my family members and friends Strongly agree
Access to my medical and personal health information anytime and anywhere	Access to my medical and personal health information anytime and anywhere Strongly disagree	Access to my medical and personal health information anytime and anywhere Disagree	Access to my medical and personal health information anytime and anywhere Neither agree nor disagree	Access to my medical and personal health information anytime and anywhere Agree	Access to my medical and personal health information anytime and anywhere Strongly agree
Allow me to better manage my appointments and set reminders	Allow me to better manage my appointments and set reminders Strongly disagree	Allow me to better manage my appointments and set reminders Disagree	Allow me to better manage my appointments and set reminders Neither agree nor disagree	Allow me to better manage my appointments and set reminders Agree	Allow me to better manage my appointments and set reminders Strongly agree
Increase my knowledge about my health condition and how to manage it	Increase my knowledge about my health condition and how to manage it Strongly disagree	Increase my knowledge about my health condition and how to manage it Disagree	Increase my knowledge about my health condition and how to manage it Neither agree nor disagree	Increase my knowledge about my health condition and how to manage it Agree	Increase my knowledge about my health condition and how to manage it Strongly agree

Other (please specify)

Question Title

* 5. How do you hope MyChart will improve your healthcare experience?

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
Improve communication between me and my care providers including doctors, nurses and other healthcare professionals	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Neither agree nor disagree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Agree	Improve communication between me and my care providers including doctors, nurses and other healthcare professionals Strongly agree
Easily share information with my family members and friends	Easily share information with my family members and friends Strongly disagree	Easily share information with my family members and friends Disagree	Easily share information with my family members and friends Neither agree nor disagree	Easily share information with my family members and friends Agree	Easily share information with my family members and friends Strongly agree
Access to my medical and personal health information anytime and anywhere	Access to my medical and personal health information anytime and anywhere Strongly disagree	Access to my medical and personal health information anytime and anywhere Disagree	Access to my medical and personal health information anytime and anywhere Neither agree nor disagree	Access to my medical and personal health information anytime and anywhere Agree	Access to my medical and personal health information anytime and anywhere Strongly agree
Allow me to better manage my appointments and set reminders	Allow me to better manage my appointments and set reminders Strongly disagree	Allow me to better manage my appointments and set reminders Disagree	Allow me to better manage my appointments and set reminders Neither agree nor disagree	Allow me to better manage my appointments and set reminders Agree	Allow me to better manage my appointments and set reminders Strongly agree
Increase my knowledge about my health condition and how to manage it	Increase my knowledge about my health condition and how to manage it Strongly disagree	Increase my knowledge about my health condition and how to manage it Disagree	Increase my knowledge about my health condition and how to manage it Neither agree nor disagree	Increase my knowledge about my health condition and how to manage it Agree	Increase my knowledge about my health condition and how to manage it Strongly agree

Other (please specify)