The information collected through this questionnaire will help shape the future of Oneida Comprehensive Health Division programs.  Some information will allow us to better understand problems that may occur early in life, and may help others in the future. An Oneida Tribal member in your household (18 years old or older) should complete the survey.  Your responses will remain confidential and will be blended with those of other participants for a group analysis.  It will only take a short time to complete the survey.
Section 1: Health Status

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* 1. Would you say that in general your health is:

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* 2. Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health NOT good?

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* 3. About how much do you weigh without shoes?

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* 4. About how tall are you without shoes?

Section 2: Health Care Access

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* 5. Do you have ANY kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare, Medical Assistance or Badgercare? (Insurance does not include Contract Health/ Purchased Referred Care)

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* 6. Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?

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* 7. Have you delayed getting needed medical care for any of the following reasons in the past 12 months? (Check all that apply)

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* 8. Do you have one person you think of as your personal primary doctor or health care provider?

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* 9. About how long has it been since you last visited a doctor for a routine checkup? A routine checkup is a general physical exam, not an exam for a specific injury, illness, or condition.

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* 10. Where do you go most frequently for primary health care services?

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* 11. How difficult is it for you to get advice or information about health or medical topics if you need it?

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* 12. How difficult is it for you to understand information that doctors, nurses and other health professionals tell you?

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