Tillamook Regional Medical Center - Community Health Survey

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* 1. What aspects of your community contribute to people’s health in a positive way?

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* 2. What aspects of your community contribute to people’s health in a negative way?

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* 3. How informed do you feel regarding implementation of the Affordable Care Act?

Very informed

Somewhat informed

Neither informed nor uninformed

Somewhat uninformed

Very uninformed

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* 4. Are there any opportunities you anticipate with the implementation of the Affordable Care Act in your
community?

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* 5. Are there any challenges you anticipate with the implementation of the Affordable Care Act in your
community?

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* 6. Which of the following behaviors do you think most contribute to maintaining positive health outcomes in your community? (Please select all that apply)

1. Eating fresh fruits and vegetables each day

2. Not using illegal substances

3. Keeping physically active

4. Sleeping at least 7 hours a day

5. Limiting alcohol (1 drink/day) or not drinking

6. Not smoking

7. Practicing faith/attending services

8. Having a support system

9. Health insurance

10. Wearing a seat belt

11. Other (please specify)

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* 7. What do you believe are the top 3 health needs of people living in the community you serve?

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* 8. What do you believe are ways to improve people’s health in your community? (Please select all that apply)

1. Improved public transportation

2. Increased access to affordable mental health services

3. Increased access to affordable medical care

4. More programs for youth

5. More access to affordable wellness type centers and services

6. More support services for the homebound and elderly

7. Increased access to healthy foods

8. Better walkable communities

9. Increased access to dental care

10. More employment opportunities

11. Access to substance abuse services

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* 9. When your clients seek medical care, are any of the following a barrier? (Please select all that apply)

1. Transportation

2. Available appointments when I am not working

3. Accessing a provider that speaks my language

4. Ability to take time off work without losing pay

5. Finding a provider that takes my insurance

6. Cost

7. Finding providers that are my same gender

8. Making timely appointments

9. Waiting times

10. Discrimination because of religion, race/ethnicity, gender?

11. Access to substance abuse services

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* 10. How would you rate your community's average health status?

	Excellent	Good	Fair	Poor
Community Health Status	Community Health Status Excellent	Community Health Status Good	Community Health Status Fair	Community Health Status Poor

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* 11. What are the race/ethnicities that your agency serves?

Asian (non Pacific Islander)

Pacific Islander

African American/Black

Latino/Hispanic

Non Hispanic White

Native American

Other (please specify)

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* 12. In your best estimate what percent of your population are:

0-17 years old

18-24 years old

25-39 years old

40-64 years old

65+ years old

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* 13. In your best estimate what percent of your population are:

Male

Female

Tillamook Regional Medical Center - Community Health Survey

1. Community Survey

Question Title

* 1. What aspects of your community contribute to people’s health in a positive way?

Question Title

* 2. What aspects of your community contribute to people’s health in a negative way?

Question Title

* 3. How informed do you feel regarding implementation of the Affordable Care Act?

Question Title

* 4. Are there any opportunities you anticipate with the implementation of the Affordable Care Act in your
community?

Question Title

* 5. Are there any challenges you anticipate with the implementation of the Affordable Care Act in your
community?

Question Title

* 6. Which of the following behaviors do you think most contribute to maintaining positive health outcomes in your community? (Please select all that apply)

Question Title

* 7. What do you believe are the top 3 health needs of people living in the community you serve?

Question Title

* 8. What do you believe are ways to improve people’s health in your community? (Please select all that apply)

Question Title

* 9. When your clients seek medical care, are any of the following a barrier? (Please select all that apply)

Question Title

* 10. How would you rate your community's average health status?

Question Title

* 11. What are the race/ethnicities that your agency serves?

Question Title

* 12. In your best estimate what percent of your population are:

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* 13. In your best estimate what percent of your population are:

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* 14. What services do you think Tillamook Regional Medical Center could offer to improve health and quality of life in the community?

Question Title

* 1. What aspects of your community contribute to people’s health in a positive way?

Question Title

* 2. What aspects of your community contribute to people’s health in a negative way?

Question Title

* 3. How informed do you feel regarding implementation of the Affordable Care Act?

Question Title

* 4. Are there any opportunities you anticipate with the implementation of the Affordable Care Act in your community?

Question Title

* 5. Are there any challenges you anticipate with the implementation of the Affordable Care Act in your community?

Question Title

* 6. Which of the following behaviors do you think most contribute to maintaining positive health outcomes in your community? (Please select all that apply)

Question Title

* 7. What do you believe are the top 3 health needs of people living in the community you serve?

Question Title

* 8. What do you believe are ways to improve people’s health in your community? (Please select all that apply)

Question Title

* 9. When your clients seek medical care, are any of the following a barrier? (Please select all that apply)

Question Title

* 10. How would you rate your community's average health status?

Question Title

* 11. What are the race/ethnicities that your agency serves?

Question Title

* 12. In your best estimate what percent of your population are:

Question Title

* 13. In your best estimate what percent of your population are:

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* 14. What services do you think Tillamook Regional Medical Center could offer to improve health and quality of life in the community?

* 4. Are there any opportunities you anticipate with the implementation of the Affordable Care Act in your
community?

* 5. Are there any challenges you anticipate with the implementation of the Affordable Care Act in your
community?