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2013 SOUTHEAST PATIENT SATISFACTION SURVEY
We'd like to ask you some questions to help us provide the best possible health care for you. Your answers are completely confidential and voluntary. Thank you.
. What is your age?
What is your age?
45 or older
. What is your race/ethnicity?
What is your race/ethnicity?
Hispanic, Latino or Spanish origin
Black or African American
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
. Do you have health insurance (Aetna, Blue Cross, Medicaid, etc.)?
Do you have health insurance (Aetna, Blue Cross, Medicaid, etc.)?
If yes, please type plan name here
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