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WALSH HOSPITAL DISTRICT v3.25
SURVEY FOR OPINION AND DISCUSSION:
Walsh Healthcare Center
Maplewood Homes
Walsh Medical Clinic
Walsh Ambulance
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* Indicates required question
Name (optional)
Your answer
Are you concerned with the future of the four entities in the Walsh Hospital District?
*
Yes
No
In what ways would the failure and closure of the above listed entities affect you and your household? (choose multiple)
*
Financial Loss
Community Loss
Economic Loss
Family, Parents, Grandparents
It wouldn't affect me
Required
Which of the following is the most valuable to you and/or your family? (Please Select One)
*
Walsh Healthcare Center
Maplewood Homes
Walsh Medical Clinic
Walsh Ambulance
Which of the following
do you feel provides the greatest overall value to our community?
*
Walsh Healthcare Center
Maplewood Homes
Walsh Medical Clinic
Walsh Ambulance
Do you know how much your property taxes will increase should the Mill Levy increase pass?
*
Yes
No
No, but I would like to know
If we have to close one of the following, due to budget restraints, which entity would you prefer losing?
*
Walsh Healthcare Center
Maplewood Homes
Walsh Medical Clinic
Walsh Ambulance
I don't want to lose any of these entities and services
What problems do you see at the
Walsh Healthcare Center?
*
Your answer
What problems do you see at
Maplewood Homes?
*
Your answer
What problems do you see at the
Walsh Medical Clinic?
*
Your answer
What problems do you see at the
Walsh Ambulance?
*
Your answer
In your opinion, what changes need to take place for each entity to be able to sustain and grow valuable service for years to come?
*
Your answer
If you choose to vote
NO
on the Mill Levy Increase, what are your biggest reasons for that decision? (Please list all)
*
Your answer
If you choose to vote
YES
on the Mill Levy Increase, what are your biggest reasons for that decision? (Please list all)
*
Your answer
Please provide your rating of the
Walsh Healthcare Center. (optional)
1
2
3
4
5
Clear selection
Please provide your rating of the
Maplewood Homes. (optional)
1
2
3
4
5
Clear selection
Please provide your rating of the
Walsh Medical Clinic. (optional)
1
2
3
4
5
Clear selection
Please provide your rating of the
Walsh Ambulance Service. (optional)
1
2
3
4
5
Clear selection
Please provide your rating of the
CARE
provided at the Walsh Healthcare Center. (optional)
1
2
3
4
5
Clear selection
Please provide your rating of the
NURSES
at the Walsh Healthcare Center. (optional)
1
2
3
4
5
Clear selection
Please provide your rating of the
ADMINISTRATION
at the Walsh Healthcare Center. (optional)
1
2
3
4
5
Clear selection
Please provide your rating of the current
NURSE PRACTITIONER
at the Walsh Medical Clinic. (optional)
1
2
3
4
5
Clear selection
Please provide your rating of the current
OFFICE STAFF
at the Walsh Medical Clinic. (optional)
1
2
3
4
5
Clear selection
Please provide your rating of the current
STAFF
at the Maplewood Homes. (optional)
1
2
3
4
5
Clear selection
Please provide your rating the current
STAFF
at the Walsh Ambulance Service. (optional)
1
2
3
4
5
Clear selection
Please provide a rating of your confidence in the
Financial Management
of Walsh Hospital District? (optional)
1
2
3
4
5
Clear selection
Please provide a rating of your confidence in the
Time
Management
of Walsh Hospital District? (optional)
1
2
3
4
5
Clear selection
Please provide a rating of your confidence in the
Leadership
of Walsh Hospital District? (optional)
1
2
3
4
5
Clear selection
Please provide a rating of your confidence in the current
Board of Directors
of the Walsh Hospital District? (optional)
1
2
3
4
5
Clear selection
What changes need to happen, for the district as a whole to be able to earn your approval and confidence for the Mill Levy Increase?
*
Your answer
Will you be attending the Community Meetings to discuss further?
*
Yes
No
Email (optional)
Your answer
Phone Number (optional)
Your answer
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