SELF-CARE ESSENTIALS PROGRAM EVALUATION Survey

Our goal is always to provide you with fun and fresh wellness incentive campaigns that assist you in making meaningful lifestyle changes. To ensure we are meeting our goal, we need to hear from you. Please answer the questions below to help us understand how you felt about the recently-completed program.

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Communicate more effectively with my Primary Care Physician (PCP).	Communicate more effectively with my Primary Care Physician (PCP). 1	Communicate more effectively with my Primary Care Physician (PCP). 2	Communicate more effectively with my Primary Care Physician (PCP). 3	Communicate more effectively with my Primary Care Physician (PCP). 4	Communicate more effectively with my Primary Care Physician (PCP). 5	Communicate more effectively with my Primary Care Physician (PCP). 6
Not make unnecessary trips to the Emergency Room and Urgent Care centers.	Not make unnecessary trips to the Emergency Room and Urgent Care centers. 1	Not make unnecessary trips to the Emergency Room and Urgent Care centers. 2	Not make unnecessary trips to the Emergency Room and Urgent Care centers. 3	Not make unnecessary trips to the Emergency Room and Urgent Care centers. 4	Not make unnecessary trips to the Emergency Room and Urgent Care centers. 5	Not make unnecessary trips to the Emergency Room and Urgent Care centers. 6
Receive my recommended immunizations and other preventive care services.	Receive my recommended immunizations and other preventive care services. 1	Receive my recommended immunizations and other preventive care services. 2	Receive my recommended immunizations and other preventive care services. 3	Receive my recommended immunizations and other preventive care services. 4	Receive my recommended immunizations and other preventive care services. 5	Receive my recommended immunizations and other preventive care services. 6
Review my medical bills carefully before paying them.	Review my medical bills carefully before paying them. 1	Review my medical bills carefully before paying them. 2	Review my medical bills carefully before paying them. 3	Review my medical bills carefully before paying them. 4	Review my medical bills carefully before paying them. 5	Review my medical bills carefully before paying them. 6
Understand my health plan and how to use it.	Understand my health plan and how to use it. 1	Understand my health plan and how to use it. 2	Understand my health plan and how to use it. 3	Understand my health plan and how to use it. 4	Understand my health plan and how to use it. 5	Understand my health plan and how to use it. 6
Become a more informed healthcare consumer and make better health decisions.	Become a more informed healthcare consumer and make better health decisions. 1	Become a more informed healthcare consumer and make better health decisions. 2	Become a more informed healthcare consumer and make better health decisions. 3	Become a more informed healthcare consumer and make better health decisions. 4	Become a more informed healthcare consumer and make better health decisions. 5	Become a more informed healthcare consumer and make better health decisions. 6

Communicate more effectively with my Primary Care Physician (PCP).

Communicate more effectively with my Primary Care Physician (PCP). 1

Communicate more effectively with my Primary Care Physician (PCP). 2

Communicate more effectively with my Primary Care Physician (PCP). 3

Communicate more effectively with my Primary Care Physician (PCP). 4

Communicate more effectively with my Primary Care Physician (PCP). 5

Communicate more effectively with my Primary Care Physician (PCP). 6

Not make unnecessary trips to the Emergency Room and Urgent Care centers.

Not make unnecessary trips to the Emergency Room and Urgent Care centers. 1

Not make unnecessary trips to the Emergency Room and Urgent Care centers. 2

Not make unnecessary trips to the Emergency Room and Urgent Care centers. 3

Not make unnecessary trips to the Emergency Room and Urgent Care centers. 4

Not make unnecessary trips to the Emergency Room and Urgent Care centers. 5

Not make unnecessary trips to the Emergency Room and Urgent Care centers. 6

Receive my recommended immunizations and other preventive care services.

Receive my recommended immunizations and other preventive care services. 1

Receive my recommended immunizations and other preventive care services. 2

Receive my recommended immunizations and other preventive care services. 3

Receive my recommended immunizations and other preventive care services. 4

Receive my recommended immunizations and other preventive care services. 5

Receive my recommended immunizations and other preventive care services. 6

Review my medical bills carefully before paying them.

Review my medical bills carefully before paying them. 1

Review my medical bills carefully before paying them. 2

Review my medical bills carefully before paying them. 3

Review my medical bills carefully before paying them. 4

Review my medical bills carefully before paying them. 5

Review my medical bills carefully before paying them. 6

Understand my health plan and how to use it.

Understand my health plan and how to use it. 1

Understand my health plan and how to use it. 2

Understand my health plan and how to use it. 3

Understand my health plan and how to use it. 4

Understand my health plan and how to use it. 5

Understand my health plan and how to use it. 6

Become a more informed healthcare consumer and make better health decisions.

Become a more informed healthcare consumer and make better health decisions. 1

Become a more informed healthcare consumer and make better health decisions. 2

Become a more informed healthcare consumer and make better health decisions. 3

Become a more informed healthcare consumer and make better health decisions. 4

Become a more informed healthcare consumer and make better health decisions. 5

Become a more informed healthcare consumer and make better health decisions. 6

SELF-CARE ESSENTIALS PROGRAM EVALUATION

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* 1. Do you plan on using the Self-Care Essentials book more in the future? (Check one)

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* 2. Did you successfully complete your online Personal Health Record? (Check one)

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* 3. Were the challenge activities easy to understand? (Check one)

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* 4. If the challenge was offered again would you recommend it to a co-worker? (Check one)

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* 5. On a scale of 1 to 6, by completing this program I am more confident in my ability to:
lowest 1 2 3 4 5 6 highest

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* 6. Address

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* 1. Do you plan on using the Self-Care Essentials book more in the future? (Check one)

Question Title

* 2. Did you successfully complete your online Personal Health Record? (Check one)

Question Title

* 3. Were the challenge activities easy to understand? (Check one)

Question Title

* 4. If the challenge was offered again would you recommend it to a co-worker? (Check one)

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* 5. On a scale of 1 to 6, by completing this program I am more confident in my ability to:lowest 1 2 3 4 5 6 highest

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* 6. Address

* 5. On a scale of 1 to 6, by completing this program I am more confident in my ability to:
lowest 1 2 3 4 5 6 highest