Q Card Evaluation - Providers
Thank you for visiting the Q Card website! In order to evaluate the Q Card, we are asking you to complete a quick survey about your experience. You do not have to provide your name or any other personal information, though you have the option of giving your email address at the end.

The Q Card was designed with the help of many local queer youth, health care providers, and youth advocates, who gave their ideas about how it should look, what it should say, and where it should be available. Now that the cards are out in the world, we want to know what you think! How did we do? What could we do differently? If you used a Q Card, how did it go? There are two surveys, one for queer youth, and one for healthcare providers, so make sure you choose the correct one! Thank you for taking the time to complete our survey, and please feel free to contact genya@qcardproject.com with any questions.

What is your specialty?
Which type of provider are you?
Has a patient ever used the Q Card in a visit?
Considering the most recent time a Q Card was used in a patient encounter, how was the Q- Card introduced in that visit?
Your answer
Did the Q Card help you talk about privacy and confidentiality?
Did the Q Card help you talk about sexual orientation/gender identity?
Did a patient disclose challenges with any of the following?
At the end of the visit, did the patient leave any portion of the Q Card with you?
Please provide any additional feedback on the Q Card content, functionality, or experience:
Your answer
In what zip code is your practice located?
Your answer
What is your sexual orientation?
Your answer
What is your gender identity?
Your answer
If you are interested in participating in a focus group about the Q Card, please provide your email address here:
Your answer
If you would like to offer Q Cards to patients at your office, please email genya@qcardproject.com to request blank copies.
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