Survey #10

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* 1. Who was your Care Advisor?

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* 2. What do you like the most about our Stay Healthy at Home Program? (Choose all that apply).

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* 3. Is there anything you don't like about our Stay Healthy at Home Program?

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* 4. Do you feel the Stay Healthy at Home Program has helped you go to the hospital less often?

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* 5. Do you feel the Stay Healthy at Home Program has made you more aware of when you are getting sick?

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* 6. Do you think taking your own vital signs everyday has helped you better manage your:

  Yes No Does not apply
COPD
CHF
Diabetes

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* 7. How much has the Stay Healthy at Home Program helped your health?

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* 8. How happy or satisfied are you with the Stay Healthy at Home Program?

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* 9. Would you recommend our Stay Healthy at Home Program to a family member or friend?

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* 10. Do you want us to call you about your survey answers?

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