Health Care Home Patient Panel Question Title * 1. Name Question Title * 2. Email and/or phone number Question Title * 3. I reside in Grand Marais Grand Portage Gunflint Trail Hovland Lutsen Schroeder Tofte Other (please specify) Question Title * 4. I am a Patient of Sawtooth Mountain Clinic Family Member of a SMC Patient Question Title * 5. Have you or a family member received care at SMC within the past year? Yes No Question Title * 6. Please tell us why you are interested in joining the Health Care Home Patient Panel. Question Title * 7. Are there any healthcare topics you wish to address as part of the Health Care Home Panel? Question Title * 8. Is there anything else you would like us to know? Done