Please select Insurance

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* 1. Please select Insurance

What is your age?

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* 2. What is your age?

When you’re considering a new physician or specialist, what are the top two things you generally consider? (Check two boxes.)

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* 3. When you’re considering a new physician or specialist, what are the top two things you generally consider? (Check two boxes.)

How long have you been going to your healthcare provider?

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* 4. How long have you been going to your healthcare provider?

In the last 12 months, how many times did you visit your healthcare provider?

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* 5. In the last 12 months, how many times did you visit your healthcare provider?

What number would you use to rate your healthcare provider? Using any number where 0 is the worst provider possible and 10 is the best provider possible

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* 6. What number would you use to rate your healthcare provider? Using any number where 0 is the worst provider possible and 10 is the best provider possible

  10 Best provider possible 9 8 7 6 5 4 3 2 1 0 Worst provider possible
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Wait time includes time spent in the waiting room and exam room. In the last 12 months, how satisfied were you with the length of time you waited to see your healthcare provider (within 30 minutes of your appointment time)?

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* 7. Wait time includes time spent in the waiting room and exam room. In the last 12 months, how satisfied were you with the length of time you waited to see your healthcare provider (within 30 minutes of your appointment time)?

How often does your healthcare provider explain things in a way that is easy to understand?

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* 8. How often does your healthcare provider explain things in a way that is easy to understand?

In the last 12 months, when your healthcare provider ordered a blood test, x-ray, or other test for you, how often did someone from thhe provider’s office follow up to give you those results?

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* 9. In the last 12 months, when your healthcare provider ordered a blood test, x-ray, or other test for you, how often did someone from thhe provider’s office follow up to give you those results?

How much further are you willing to travel for services not provided at your physician's office? (Such as labs, imaging and prescriptions)

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* 10. How much further are you willing to travel for services not provided at your physician's office? (Such as labs, imaging and prescriptions)

If your provider extended their office hours, what would you prefer from the list below? Pick up to two.

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* 11. If your provider extended their office hours, what would you prefer from the list below? Pick up to two.

How important is it that your physician's office has cutting-edge technology?

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* 12. How important is it that your physician's office has cutting-edge technology?

Have you had a virtual office visit? (Computer or phone such as Skype or Face Time)

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* 13. Have you had a virtual office visit? (Computer or phone such as Skype or Face Time)

If your provider could perform a follow-up visit, such as management of diabetes, via the internet. How likely would you be to choose the internet versus an onsite appointment?

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* 14. If your provider could perform a follow-up visit, such as management of diabetes, via the internet. How likely would you be to choose the internet versus an onsite appointment?

If your provider could offer virtual visits, what would you be willing to pay out of pocket for the visit? Does not include insurance reimbursement

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* 15. If your provider could offer virtual visits, what would you be willing to pay out of pocket for the visit? Does not include insurance reimbursement

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