Patient Survey
This survey is anonymous. You cannot be identified in any way. Participation is voluntary. All data collected is encrypted, secured and analyzed to enhance your experience as a patient.
Language fluency
Required
Age
Years
18-19
20-29
30-39
40-49
50-59
60-69
70-79
80-89
90+
Device access
Personal
Relative
No access
Home internet
Home phone
Text-messaging
Smart-phone (data plan)
E-mail
Patient Portal
A patient portal is a secure online website that gives patients convenient 24-hour access to personal health information from anywhere with an Internet connection. Using a secure username and password, patients can interact with their health information and providers.
Are you aware of the Patient Portal?
Which features interest you?
Yes
No
Indifferent
View lab results
View future appointments
Appointment notifications and reminders
Send and receive messages from provider
Request medication refills
Request medical records
View summaries of your visits
Targeted educational information
Missing feature?
Your answer
How would you prefer to communicate?
Required
ELECTRONIC CONSENT
This survey is anonymous. You cannot be identified in any way. Participation is voluntary. All data collected is encrypted and secured and analyzed to enhance your experience as a patient.

Data will be used to improve patient-physician communication and foster patient empowerment.

There are no known risks or costs should you decide to participate.

While data collected may not benefit you directly, it may provide general benefits to patients, providers, and system efficacy.

Selecting "agree" indicates you read above and consent voluntarily (THANK YOU!)
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