Access to Health Services

Survey Introduction

Please take a moment to complete this brief survey. The purpose of this survey is to get your opinions about the availability of health services in Linn County, IA. Health services may include medical, dental, mental health, prescription, and health education services. This assessment is part of the 2015 Community Health Assessment being driven by a collaborative group called Together! Healthy Linn. Together! Healthy Linn consists of many different organizations, including the hospitals and clinics, not-for-profit agencies, and governmental departments. The Together! Healthy Linn committee will use the results of this survey to identify what to address related to making health services easier for community members to access.

The survey should be completed no later than June 12, 2015. The survey may be completed electronically at http://bit.ly/LinnAccess or delivered to Linn County Public Health at:

Attn: Amy Lepowsky

501 13th St NW

Cedar Rapids, IA 52405

If you have any questions about this survey, please contact Amy by calling 319.892.6082 or through email at amy.lepowsky@linncounty.org.

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* 1. Do you go to a primary care physician regularly ? (Check all that apply)

Yes, for annual check-ups

Yes, when I am sick or injured

If no, why not? (please specify)

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* 2. Do you go to the dentist regularly? (Check all that apply)

At least once a year

When I have a dental emergency

If no, why not? (please specify)

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* 3. Do you have access to information about health, how to improve your health, or how to manage medical conditions?

Yes

Somewhat

If no, what types of health education services would you like to see available?

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* 4. What types of transportation do you use to get to health-related appointments (check all that apply)?

I own my own vehicle

Family member or friend drives me

I ride my bike

I take the city bus

I walk to my appointments

Other bus service (NTS, LIFTS, etc.)

Taxi cab

Other (please specify)

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* 5. Please rate the questions below based on your experience

	Never	Hardly ever	Sometimes	Most of the time
Do you feel that you are able to see a doctor when needed?	Do you feel that you are able to see a doctor when needed? Never	Do you feel that you are able to see a doctor when needed? Hardly ever	Do you feel that you are able to see a doctor when needed? Sometimes	Do you feel that you are able to see a doctor when needed? Most of the time
If needed, are you able to see a mental health provider when needed?	If needed, are you able to see a mental health provider when needed? Never	If needed, are you able to see a mental health provider when needed? Hardly ever	If needed, are you able to see a mental health provider when needed? Sometimes	If needed, are you able to see a mental health provider when needed? Most of the time
Do you tend to make health decisions based on your ability to afford services?	Do you tend to make health decisions based on your ability to afford services? Never	Do you tend to make health decisions based on your ability to afford services? Hardly ever	Do you tend to make health decisions based on your ability to afford services? Sometimes	Do you tend to make health decisions based on your ability to afford services? Most of the time
Do you tend to make health decisions based on your ability to get to the clinic or needed services?	Do you tend to make health decisions based on your ability to get to the clinic or needed services? Never	Do you tend to make health decisions based on your ability to get to the clinic or needed services? Hardly ever	Do you tend to make health decisions based on your ability to get to the clinic or needed services? Sometimes	Do you tend to make health decisions based on your ability to get to the clinic or needed services? Most of the time

If you answered "Never" or "Hardly ever" to any of the above questions, please explain why not?

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* 6. What types of services are needed that you are not currently receiving because of cost? If cost is not an issue, please skip to question 8

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* 7. If available, what types of reduced-cost health services would you use?

Dental Care

Annual physical

Medical appointment

Prescription

Mental health services

Please describe any other health services that you would use if available...

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* 8. What are some things that make it difficult to get the health services that are needed?

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* 9. Do you know who to talk to if you need help finding the services that are available to you?

Yes

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* 10. What would you like to see be done to improve your ability get health services when they are needed?

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* 11. What zip code do you live in?

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* 12. Do you know who to talk to if you need help obtaining health insurance?

Yes

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* 13. If you would like more information about services available in Linn County, please fill-in your contact information below

Name

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

Thank you for your participation! Your feedback is valuable in helping us improve the services offered to Linn County residents.

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* 1. Do you go to a primary care physician regularly ? (Check all that apply)

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* 2. Do you go to the dentist regularly? (Check all that apply)

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* 3. Do you have access to information about health, how to improve your health, or how to manage medical conditions?

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* 4. What types of transportation do you use to get to health-related appointments (check all that apply)?

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* 5. Please rate the questions below based on your experience

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* 6. What types of services are needed that you are not currently receiving because of cost? If cost is not an issue, please skip to question 8

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* 7. If available, what types of reduced-cost health services would you use?

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* 8. What are some things that make it difficult to get the health services that are needed?

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* 9. Do you know who to talk to if you need help finding the services that are available to you?

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* 10. What would you like to see be done to improve your ability get health services when they are needed?

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* 11. What zip code do you live in?

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* 12. Do you know who to talk to if you need help obtaining health insurance?

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* 13. If you would like more information about services available in Linn County, please fill-in your contact information below

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* 14. If applicable, please describe which services you are interested in learning more about