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Surveys
2012
November
U
UKB HHS Sf 11.03.12
UKB HHS Sf 11.03.12
Anonoymous SURVEY
0%
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for Health and Human Services
so that we may better understand your needs
.
This survey should take less than one minute of your time.
Have you ever been seen or visited by a Community Health Representative?
Yes
No
I don’t know what that is
Would you use a Community Health Representative who will help you understand or address your health needs through free home visits, rides to doctor appointments, educational events and emergency transport assistance?
Probably
Probably not
I don’t know
When using Indian Health Service, have you ever used Contract Health Services (sent to a private doctor outside of IHS)?
Yes
No
If you were denied for IHS Contract Health Services, what was the reason?
I was not denied
I was not qualified
Funding ran out
I was not a priority
I don't know why I was turned down
If you were denied a referral through HIS Contract Health Services did you?
I was not denied
Still waiting for a referral
Eventually got a referral after some time
Go to a private doctor on your private insurance
Go to another Indian Health Service outside your usual hospital
If the UKB Tribe had to pay for its own programs which to you consider the most important?
Community Health Representative
Contract Health Services
Both
Undecided
Are you?
Male
Female
I'd rather not say
Are you a senior?
Yes
No
I'd rather not say
Which district do you live in?
Canadian
Cooweescoowee
Delaware
Flint
Goingsnake
Illinois
Salina
Sequoyah
Tahlequah
Outside of the districts
I'd rather not say
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