HOW ARE WE DOING?

How well you think North Country Family Health Center is meeting your needs?.
This survey is anonymous. If you would like a response to your concerns, please give us your contact information by sharing your comments directly with Cheryl Fazio, our Clinical Operations Officer, by email at cfazio@NoCoFamilyHealth.org or by writing to her at 238 Arsenal Street, Watertown, NY 13601.
Thank you so much for taking the time to share your thoughts with us.

Please tell is how you think we are doing meeting our program goals:

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* 1. Getting Care or Advice

	Great	Good	OK	Fair	Bad	Doesn't Apply
Able to get an appointment when you need one	Able to get an appointment when you need one Great	Able to get an appointment when you need one Good	Able to get an appointment when you need one OK	Able to get an appointment when you need one Fair	Able to get an appointment when you need one Bad	Able to get an appointment when you need one Doesn't Apply
Phone calls get through easily	Phone calls get through easily Great	Phone calls get through easily Good	Phone calls get through easily OK	Phone calls get through easily Fair	Phone calls get through easily Bad	Phone calls get through easily Doesn't Apply
Total time you waited - from start to finish	Total time you waited - from start to finish Great	Total time you waited - from start to finish Good	Total time you waited - from start to finish OK	Total time you waited - from start to finish Fair	Total time you waited - from start to finish Bad	Total time you waited - from start to finish Doesn't Apply
Able to get medical advice when the office is closed	Able to get medical advice when the office is closed Great	Able to get medical advice when the office is closed Good	Able to get medical advice when the office is closed OK	Able to get medical advice when the office is closed Fair	Able to get medical advice when the office is closed Bad	Able to get medical advice when the office is closed Doesn't Apply
Checking with you after we sent you for lab tests or to a specialist	Checking with you after we sent you for lab tests or to a specialist Great	Checking with you after we sent you for lab tests or to a specialist Good	Checking with you after we sent you for lab tests or to a specialist OK	Checking with you after we sent you for lab tests or to a specialist Fair	Checking with you after we sent you for lab tests or to a specialist Bad	Checking with you after we sent you for lab tests or to a specialist Doesn't Apply

Question Title

* 2. Front Desk Staff (the people who answer the phones)

	Great	Good	OK	Fair	Bad	Doesn't Apply
Are friendly and helpful	Are friendly and helpful Great	Are friendly and helpful Good	Are friendly and helpful OK	Are friendly and helpful Fair	Are friendly and helpful Bad	Are friendly and helpful Doesn't Apply

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* 3. Nurses, Hygienists, Assistants

	Great	Good	OK	Fair	Bad	Doesn't apply
Listens to you	Listens to you Great	Listens to you Good	Listens to you OK	Listens to you Fair	Listens to you Bad	Listens to you Doesn't apply
Is friendly and helpful	Is friendly and helpful Great	Is friendly and helpful Good	Is friendly and helpful OK	Is friendly and helpful Fair	Is friendly and helpful Bad	Is friendly and helpful Doesn't apply
Answers your questions	Answers your questions Great	Answers your questions Good	Answers your questions OK	Answers your questions Fair	Answers your questions Bad	Answers your questions Doesn't apply
Explains treatments clearly	Explains treatments clearly Great	Explains treatments clearly Good	Explains treatments clearly OK	Explains treatments clearly Fair	Explains treatments clearly Bad	Explains treatments clearly Doesn't apply

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* 4. Provider (Doctor, Dentist, Nurse Practitioner,Physician Assistant, Psychologist, or Therapist)

	Great	Good	OK	Fair	Bad	Doesn't apply
Listens to you	Listens to you Great	Listens to you Good	Listens to you OK	Listens to you Fair	Listens to you Bad	Listens to you Doesn't apply
Spends enough time with you	Spends enough time with you Great	Spends enough time with you Good	Spends enough time with you OK	Spends enough time with you Fair	Spends enough time with you Bad	Spends enough time with you Doesn't apply
Answers your questions	Answers your questions Great	Answers your questions Good	Answers your questions OK	Answers your questions Fair	Answers your questions Bad	Answers your questions Doesn't apply
Is friendly and helpful	Is friendly and helpful Great	Is friendly and helpful Good	Is friendly and helpful OK	Is friendly and helpful Fair	Is friendly and helpful Bad	Is friendly and helpful Doesn't apply
Involves other doctors, specialists, or caregivers when needed	Involves other doctors, specialists, or caregivers when needed Great	Involves other doctors, specialists, or caregivers when needed Good	Involves other doctors, specialists, or caregivers when needed OK	Involves other doctors, specialists, or caregivers when needed Fair	Involves other doctors, specialists, or caregivers when needed Bad	Involves other doctors, specialists, or caregivers when needed Doesn't apply
Gives advice and treatment you understand	Gives advice and treatment you understand Great	Gives advice and treatment you understand Good	Gives advice and treatment you understand OK	Gives advice and treatment you understand Fair	Gives advice and treatment you understand Bad	Gives advice and treatment you understand Doesn't apply
Respects your family or personal beliefs	Respects your family or personal beliefs Great	Respects your family or personal beliefs Good	Respects your family or personal beliefs OK	Respects your family or personal beliefs Fair	Respects your family or personal beliefs Bad	Respects your family or personal beliefs Doesn't apply

Question Title

* 5. Our Family Health Center

	Great	Good	OK	Fair	Bad	Doesn't Apply
Health Center hours work for me	Health Center hours work for me Great	Health Center hours work for me Good	Health Center hours work for me OK	Health Center hours work for me Fair	Health Center hours work for me Bad	Health Center hours work for me Doesn't Apply
Health Center location is easy to get to	Health Center location is easy to get to Great	Health Center location is easy to get to Good	Health Center location is easy to get to OK	Health Center location is easy to get to Fair	Health Center location is easy to get to Bad	Health Center location is easy to get to Doesn't Apply
Health Center communicates with me in ways I can understand	Health Center communicates with me in ways I can understand Great	Health Center communicates with me in ways I can understand Good	Health Center communicates with me in ways I can understand OK	Health Center communicates with me in ways I can understand Fair	Health Center communicates with me in ways I can understand Bad	Health Center communicates with me in ways I can understand Doesn't Apply

Question Title

* 6. Your Visit

	Yes	No	Doesn't apply to me
Did anyone ask you if you/your child have any problems with medicine you take?	Did anyone ask you if you/your child have any problems with medicine you take? Yes	Did anyone ask you if you/your child have any problems with medicine you take? No	Did anyone ask you if you/your child have any problems with medicine you take? Doesn't apply to me
Do you have problems getting medicine for you/ your child (transportation or cost)?	Do you have problems getting medicine for you/ your child (transportation or cost)? Yes	Do you have problems getting medicine for you/ your child (transportation or cost)? No	Do you have problems getting medicine for you/ your child (transportation or cost)? Doesn't apply to me
Did someone talk with you about things you/your child can do to be healthier?	Did someone talk with you about things you/your child can do to be healthier? Yes	Did someone talk with you about things you/your child can do to be healthier? No	Did someone talk with you about things you/your child can do to be healthier? Doesn't apply to me
Did you get a copy of that advice or instruction to take home with you?	Did you get a copy of that advice or instruction to take home with you? Yes	Did you get a copy of that advice or instruction to take home with you? No	Did you get a copy of that advice or instruction to take home with you? Doesn't apply to me
Do you think you will follow any advice or instructions we gave you?	Do you think you will follow any advice or instructions we gave you? Yes	Do you think you will follow any advice or instructions we gave you? No	Do you think you will follow any advice or instructions we gave you? Doesn't apply to me

Question Title

* 7. Your Experience

	Yes	No	Doesn't Apply
I/my child(ren) use NCFHC HEALTH services	I/my child(ren) use NCFHC HEALTH services Yes	I/my child(ren) use NCFHC HEALTH services No	I/my child(ren) use NCFHC HEALTH services Doesn't Apply
I/my child(ren) use NCFHC Behavioral Health COUNSELING services	I/my child(ren) use NCFHC Behavioral Health COUNSELING services Yes	I/my child(ren) use NCFHC Behavioral Health COUNSELING services No	I/my child(ren) use NCFHC Behavioral Health COUNSELING services Doesn't Apply
I/my child(ren) use NCFHC DENTAL services	I/my child(ren) use NCFHC DENTAL services Yes	I/my child(ren) use NCFHC DENTAL services No	I/my child(ren) use NCFHC DENTAL services Doesn't Apply
I/my child(ren) use NCFHC WIC services	I/my child(ren) use NCFHC WIC services Yes	I/my child(ren) use NCFHC WIC services No	I/my child(ren) use NCFHC WIC services Doesn't Apply
If you/your child(ren) needs services that we do not provide: Have we helped you find the other services you need?	If you/your child(ren) needs services that we do not provide: Have we helped you find the other services you need? Yes	If you/your child(ren) needs services that we do not provide: Have we helped you find the other services you need? No	If you/your child(ren) needs services that we do not provide: Have we helped you find the other services you need? Doesn't Apply
Would you tell friends or family to use our school-based health center?	Would you tell friends or family to use our school-based health center? Yes	Would you tell friends or family to use our school-based health center? No	Would you tell friends or family to use our school-based health center? Doesn't Apply
Do you understand your bill?	Do you understand your bill? Yes	Do you understand your bill? No	Do you understand your bill? Doesn't Apply
Do you feel what you pay is reasonable?	Do you feel what you pay is reasonable? Yes	Do you feel what you pay is reasonable? No	Do you feel what you pay is reasonable? Doesn't Apply

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* 8. About You

	Yes	No
Are you/your family covered by insurance?	Are you/your family covered by insurance? Yes	Are you/your family covered by insurance? No
Do you/your family have stable housing?	Do you/your family have stable housing? Yes	Do you/your family have stable housing? No

HOW ARE WE DOING?

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* 1. Getting Care or Advice

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* 2. Front Desk Staff (the people who answer the phones)

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* 3. Nurses, Hygienists, Assistants

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* 4. Provider (Doctor, Dentist, Nurse Practitioner,Physician Assistant, Psychologist, or Therapist)

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* 5. Our Family Health Center

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* 6. Your Visit

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* 7. Your Experience

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* 8. About You

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* 9. What do you think we do well?

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* 10. What do you think we could do better?