myClinicOnline Feedback Form Question Title * 1. Is this the first time you have visited myClinicOnline? Yes No Question Title * 2. What is your primary device to access internet? Smartphone Tablet Computer Question Title * 3. How did you access myClinicOnline? www.myClinicOnline.org www.nwcovna.org Healow mobile app Question Title * 4. How often do you access the internet? Every Day A few times a week Once a week Less than once a week Hardly ever Question Title * 5. Is the process for logging into myClinicOnline clear? Yes No Question Title * 6. Does the menu of items on the home page give you the option you need? Yes No Other (please specify) Question Title * 7. What features of myClinicOnline do you utilize (check all that apply)? Message Provider Appointment Request Medication Refill Update Personal Information View Lab Results View Personal Health Information View Immunizations Question Title * 8. Is the information you want on myClinicOnline? Yes No Other (please specify) Question Title * 9. Is the information easy to understand? Yes No Question Title * 10. Is the information easy to find? Yes No Question Title * 11. Please provide any other feedback below: Question Title * 12. Is it ok for a staff member to call and discuss this feedback with you? Yes No If yes, please enter your name and email or phone number below Done