Patient Satisfaction Survey - CAHPS Adult - English Question Title * 1. What location are you receiving medical care at? 281 Main Street, East Hartford 16 Coventry Street, Hartford 828 Sullivan Ave, South Windsor Question Title * 2. Our records show that you received care from a provider named below in the last 6 months. Please select the provider name below. Sonya Harris, APRN Michelle Hibbert, APRN Christina Morrissey, DNP Anthony Veturis, APRN Dr. B Dr. P Dr. W Dr. Chad McDonald Caitlin Putnam, APRN Sharon Fong, APRN Rebecca Peiper, APRN Dr. Zachary Steinbach Question Title * 3. Do you receive Medication Assisted Treatment with InterCommunity for Opioid Use Disorder? Yes No Question Title * 4. The questions in this survey will refer to the provider named in Question 2 as “this provider.” Please think of that person as you answer the survey. Is this the provider you usually see if you need a check-up, want advice about a health problem, or get sick or hurt? Yes No Question Title * 5. What days of the week do you prefer to meet with your provider? Monday Tuesday Wednesday Thursday Friday Saturday Question Title * 6. What time of day do you prefer to meet with your provider? Early morning 9 A.M to 5 P.M. After 5 P.M. Question Title * 7. How long have you been going to this provider? Less than 6 months At least 6 months but less than 1 year At least 1 year but less than 3 years At least 3 years but less than 5 years 5 years or more Question Title * 8. These questions ask about your own health care. Do not include care you got when you stayed overnight in a hospital. Do not include the times you went for dental care visits.In the last 6 months, how many times did you visit this provider to get care for yourself? None (if None, go to Question #27) 1 time 2 3 4 5 to 9 10 or more times Question Title * 9. In the last 6 months, did you contact this provider’s office to get an appointment for an illness, injury, or condition that needed care right away? Yes No (if No, go to Question #11) Question Title * 10. In the last 6 months, when you contacted this provider’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed? Never Sometimes Usually Always Question Title * 11. In the last 6 months, did you make any appointments for a check-up or routine care with this provider? Yes No (If No, go to Question #13) Question Title * 12. In the last 6 months, when you made an appointment for a check-up or routine care with this provider, how often did you get an appointment as soon as you needed? Never Sometimes Usually Always Question Title * 13. In the last 6 months, did you contact this provider’s office with a medical question during regular office hours? Yes No (if No, go to Question #15) Question Title * 14. In the last 6 months, when you contacted this provider’s office during regular office hours, how often did you get an answer to your medical question that same day? Never Sometimes Usually Always Question Title * 15. In the last 6 months, how often did this provider explain things in a way that was easy to understand? Never Sometimes Usually Always Question Title * 16. In the last 6 months, how often did this provider listen carefully to you? Never Sometimes Usually Always Question Title * 17. In the last 6 months, how often did this provider seem to know the important information about your medical history? Never Sometimes Usually Always Question Title * 18. In the last 6 months, how often did this provider show respect for what you had to say? Never Sometimes Usually Always Question Title * 19. In the last 6 months, how often did this provider spend enough time with you? Never Sometimes Usually Always Question Title * 20. In the last 6 months, did this provider order a blood test, x-ray, or other test for you? Yes No (if no, go to Question #22) Question Title * 21. In the last 6 months, when this provider ordered a blood test, x-ray, or other test for you, how often did someone from this provider’s office follow up to give you those results? Never Sometimes Usually Always Question Title * 22. Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate this provider? 0 - Worst provider possible 1 2 3 4 5 6 7 8 9 10 - Best provider possible Question Title * 23. In the last 6 months, did you take any prescription medicine? Yes No (If No, go to question #25) Question Title * 24. In the last 6 months, how often did you and someone from this provider’s office talk about all the prescription medicines you were taking? Never Sometimes Usually Always Question Title * 25. In the last 6 months, how often were clerks and receptionists at this provider’s office as helpful as you thought they should be? Never Sometimes Usually Always Question Title * 26. In the last 6 months, how often did clerks and receptionists at this provider’s office treat you with courtesy and respect? Never Sometimes Usually Always Question Title * 27. In general, how would you rate your overall health? Excellent Very good Good Fair Poor Question Title * 28. In general, how would you rate your overall mental or emotional health? Excellent Very good Good Fair Poor Question Title * 29. What is your age? 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Question Title * 30. Are you male or female? Male Female Question Title * 31. What is the highest level of school that you have completed? 8th grade or less Some high school, but did not graduate High school graduate or GED Some college or 2-year degree 4-year college graduate More than 4-year college degree Question Title * 32. Are you of Hispanic or Latino origin or descent? Yes, Hispanic or Latino No, not Hispanic or Latino Question Title * 33. What is your race. Mark one or more. White Black or African American Asian Native Hawaiian or Other Pacific Islander American Indian or Alaska Native Other Question Title * 34. Did someone help you complete the survey? Yes (if yes, answer Question #35) No (if no, you have completed the survey) Question Title * 35. How did that person help you? Mark one or more. Read the questions to me Selected the answers I gave Answered the questions for me Translated the questions into my language Helped in some other way Question Title * 36. Is there anything our Practice can do to improve care and services we provide to you? Done