Telehealth Survey

HRHN is trying to gather information about the Telehealth options that are currently available through providers in Charlotte, DeSoto, Hardee, Highlands, and Polk Counties, FL. We are gathering the information for purposes of developing a public awareness telemedicine campaign.

Question Title

* 1. Please provide your contact information.

Name and Title

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 2. In what counties do you provide services?

Charlotte County, Florida

DeSoto County, Florida

Hardee County, Florida

Highlands County, Florida

Polk County, Florida

Other (please specify)

Question Title

* 3. Does your organization currently provide telehealth services?

Yes

Question Title

* 4. What telehealth/telemedicine services do you offer?

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* 5. Must patients be established already prior to being eligible for telehealth services? If you offer more than 1 telehealth services, please explain if your answer applies to all or some, and if only some, please list which ones require prior eligibility.

Yes, patients must be established through a face-to-face visit before utilizing any of our telehealth services.

For some services, patients must be established prior to being eligible for telehealth services (please list those that require prior eligibility in the comments section below).

No, patients do not need to be established with us prior to utilizing our telehealth services.

Please provide a list of which services require being an established patient prior to eligibility (if not all).

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* 6. How would a patient access your telehealth services?

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* 7. Do you currently have any marketing materials for your telehealth services?

Yes

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* 8. If you have marketing materials, would you be willing to provide it to HRHN?

Yes

N/A

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* 9. Would you like to discuss how HRHN can help you market your telehealth programs?

Yes

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* 10. Do you feel that anything other than lack of knowledge of telehealth services available keeps patients from utilizing your telehealth services? If so, please summarize the barriers you feel patients have to utilizing telehealth.

Telehealth Survey

Question Title

* 1. Please provide your contact information.

Question Title

* 2. In what counties do you provide services?

Question Title

* 3. Does your organization currently provide telehealth services?

Question Title

* 4. What telehealth/telemedicine services do you offer?

Question Title

* 5. Must patients be established already prior to being eligible for telehealth services? If you offer more than 1 telehealth services, please explain if your answer applies to all or some, and if only some, please list which ones require prior eligibility.

Question Title

* 6. How would a ﻿patient access your telehealth services?

Question Title

* 7. Do you currently have any marketing materials for your telehealth services?

Question Title

* 8. If you have marketing materials, would you be willing to provide it to HRHN?

Question Title

* 9. Would you like to discuss how HRHN can help you market your telehealth programs?

Question Title

* 10. Do you feel that anything other than lack of knowledge of telehealth services available keeps patients from utilizing your telehealth services? If so, please summarize the barriers you feel patients have to utilizing telehealth.

* 6. How would a patient access your telehealth services?