Warsaw Community Survey
Memorial Hospital seeks to better understand the healthcare needs of the Warsaw community. Please take a moment to complete this brief survey, which will assist us in tailoring our services to meet your needs effectively.
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1.
What is your zip code?
(Required.)
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2.
Do you have a primary healthcare provider?
(Required.)
Yes
No
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3.
If you do have a primary healthcare provider who do you see?
(Required.)
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4.
Do you utilize any of these services in Hamilton, IL:
(Required.)
Pediatrics
Primary Care
Orthopedics (Bone Dr.)
Behavioral Health
I do not use services in Hamilton
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5.
If no to question 4, which of these services would you utilize in Hamilton, IL:
(Required.)
Pediatrics
Primary Care
Orthopedics (Bone Dr.)
Behavioral Health
Podiatry (Foot Dr.)
I would not use services in Hamilton
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6.
What barriers might prevent you from receiving healthcare?
(Required.)
Lack of transportation
No appointments available
Financial barrier (could not afford)
Did not know how to find provider
Inconvenient appointment times
N/A
Other (please specify)
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7.
What healthcare services would like to see more of locally?
(Required.)
Acupuncture
Integrative/Functional Medicine
Mental/Behavioral Health Services
Substance Misuse
Ear/Nose/Throat
Health Coaching
Dietitian Services
Urology Services
Cardiology
Oncology/Cancer Care
Orthopedics
Pediatrics
Gastroenterology
Nephrology
Dermatology
Rheumatology
Gynecology
Obstetrics
Pulmonology
Vision/Ophthalmology Services
Neurology
Podiatry (Foot Dr.)
Other (please specify)
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8.
Is there anything else you would like us to know?
(Required.)