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Rural Veterans Survey for Providers that are Members of Health Networks

Questions about healhtcare services for veterans

This survey is for healthcare providers that are members of health networks. We are collecting data for the Department of Veterans Affairs - Office of Rural Health. The data will be analyzed and presented at the National Cooperative of Health Networks (NCHN) Leadership Summit on October 2, 2013 in Austin, TX.



1.Do you or your staff ask your patients if they are Veterans?
2.If not, do you know if your clinic serves any Veterans?
3.How many Veterans would you say your clinic serves annually? (if unsure, your best guess is ok)
4.If your answer to Q3 is more than zero:
Do you know if the Veterans you see in your clinic also use the VA for some of their health care?
5.If you answered yes to Q4:
Has care coordination between your clinic and the VA ever been an issue?
6.Does your clinic or network exchange patient health care information with any VA facilities?
7.If yes to Q6:
Do you exchange information electronically through Health Information Exchange (HIE), or do you use fax/mail/hand carry to do so?
8.How do you rate your knowledge of VA eligibility requirements for Veterans to receive health care from the VA?
9.Are you willing to refer Veteran patients to the VA for health care?
10.Would you say you/your providers are confident in their ability to screen Veterans for Traumatic Brain Injuries?
11.Would you say you/your providers are confident in their ability to treat Veterans for Traumatic Brain Injuries?
12.Please provide any additional comments about working with rural veterans that you would like to share:
13.What type of healthcare provider are you? (e.g., CAH, RHC, Physician Office/Clinic; FQHC, Public Health Department, etc.)
14.What state are you located in?
15.For the person completing the survey, what is your title/position?
16.If you would like a copy of the final report of this survey, please provide your name and email address.
Thank you for completing the survey!