Provider E-News Update Survey

Give us your feedback! This brief survey will only take a few minutes to complete, honest! Thanks in advance for your time.

Question Title

1. What type of provider are you? (check one)

Social Worker

Nurse

Physician

Other health care/clinical provider

Other social services/community services provider

Other (please specify)

Question Title

2. What do you like about the FCA Provider E-News Update? (check all that apply)

I learn about the needs/challenges of family caregivers

It provides helpful resources

It makes it easier for me to identify and help family caregivers

It helps to keep me updated on FCA's work

Please provide some detail:

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3. How can we make the Provider E-News Update more valuable to you?

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4. How likely are you to share featured resources and FCA info with family caregivers?

Very Likely

Likely

Neutral

Unlikely

Very Unlikely

Very Likely

Likely

Neutral

Unlikely

Very Unlikely

Other (please specify)

Question Title

5. How likely are you to refer caregivers to FCA for information or support?

Very Likely

Likely

Neutral

Unlikely

Very Unlikely

Very Likely

Likely

Neutral

Unlikely

Very Unlikely

Other (please specify)

Question Title

6. How likely are you to share this newsletter with other providers?

Very Likely

Likely

Neutral

Unlikely

Very Unlikely

Very Likely

Likely

Neutral

Unlikely

Very Unlikely

Other (please specify)

Question Title

* 1. What type of provider are you? (check one)

Question Title

* 2. What do you like about the FCA Provider E-News Update? (check all that apply)

Question Title

* 3. How can we make the Provider E-News Update more valuable to you?

Question Title

* 4. How likely are you to share featured resources and FCA info with family caregivers?

Question Title

* 5. How likely are you to refer caregivers to FCA for information or support?

Question Title

* 6. How likely are you to share this newsletter with other providers?

Question Title

* 7. Please share any additional feedback (optional)

1. What type of provider are you? (check one)

2. What do you like about the FCA Provider E-News Update? (check all that apply)

3. How can we make the Provider E-News Update more valuable to you?

4. How likely are you to share featured resources and FCA info with family caregivers?

5. How likely are you to refer caregivers to FCA for information or support?

6. How likely are you to share this newsletter with other providers?

7. Please share any additional feedback (optional)