AST Health Services Community Needs Assessment

Question Title

1. When visiting the clinic, how often do the staff explain things in a way that you understand?

Always

Usually

Sometimes

Never

Always

Usually

Sometimes

Never

Question Title

2. When visiting the clinic, how often do the providers (physicians, dentists, behavior health counselors, etc.) listen carefully to you?

Always

Usually

Sometimes

Never

Always

Usually

Sometimes

Never

Question Title

3. When visiting the clinic, do the staff do everything that they can to help you with your health issues (ie., pain management, prescription refills, physicals, complaints, etc.)?

Always

Usually

Sometimes

Never

N/A

Always

Usually

Sometimes

Never

N/A

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4. Would you recommend this clinic to your friends and family?

Definitely

Probably

Unlikely

Definitely

Probably

Unlikely

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5. In general, how would you rate your overall health?

Excellent

Very Good

Good

Fair

Poor

Excellent

Very Good

Good

Fair

Poor

Question Title

6. What is the highest level of school that you have completed?

8th grade or less

Some high school, but did not graduate

High school graduate or GED

Some college or 2-year degree

4-year college graduate

More than 4-year college degree

8th grade or less

Some high school, but did not graduate

High school graduate or GED

Some college or 2-year degree

4-year college graduate

More than 4-year college degree

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7. What is your race? Please choose one or more.

Native American

Hispanic/Latino

White

Black/African American

Asian

Other

Native American

Hispanic/Latino

White

Black/African American

Asian

Other

Please specify Tribe (ie., AST, Cherokee, etc.)

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8. What kind of things impact the health of your neighbors and you the most?

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9. What is keeping you and your neighbors healthy?

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10. What 3-5 things could be done in your community to improve the health of your neighbors and you (ie., new services, technology, tele-health, hours of operation, etc.)?

Question Title

* 1. When visiting the clinic, how often do the staff explain things in a way that you understand?

Question Title

* 2. When visiting the clinic, how often do the providers (physicians, dentists, behavior health counselors, etc.) listen carefully to you?

Question Title

* 3. When visiting the clinic, do the staff do everything that they can to help you with your health issues (ie., pain management, prescription refills, physicals, complaints, etc.)?

Question Title

* 4. Would you recommend this clinic to your friends and family?

Question Title

* 5. In general, how would you rate your overall health?

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* 6. What is the highest level of school that you have completed?

Question Title

* 7. What is your race? Please choose one or more.

Question Title

* 8. What kind of things impact the health of your neighbors and you the most?

Question Title

* 9. What is keeping you and your neighbors healthy?

Question Title

* 10. What 3-5 things could be done in your community to improve the health of your neighbors and you (ie., new services, technology, tele-health, hours of operation, etc.)?

1. When visiting the clinic, how often do the staff explain things in a way that you understand?

2. When visiting the clinic, how often do the providers (physicians, dentists, behavior health counselors, etc.) listen carefully to you?

3. When visiting the clinic, do the staff do everything that they can to help you with your health issues (ie., pain management, prescription refills, physicals, complaints, etc.)?

4. Would you recommend this clinic to your friends and family?

5. In general, how would you rate your overall health?

6. What is the highest level of school that you have completed?

7. What is your race? Please choose one or more.

8. What kind of things impact the health of your neighbors and you the most?

9. What is keeping you and your neighbors healthy?

10. What 3-5 things could be done in your community to improve the health of your neighbors and you (ie., new services, technology, tele-health, hours of operation, etc.)?