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Kansas Health P260207

Please provide us with your First and Last Name

Please provide us with your email address.

Which of the following statements best describes who in your household is responsible for healthcare decisions for you and/or your family?

Which of the following statements best describes who in your household is responsible for healthcare decisions for you and/or your family?

A

I am the person most responsible

B

I share responsibility with someone else

C

Someone else is most responsible

D

Prefer not to answer

E

Don’t know / not sure

Thinking about healthcare systems or healthcare providers in your area, how familiar would you say you are with each of the following?

	Aware and Familiar	Aware, Not Familiar	Not Aware
The University of Kansas Health System
Ashland Health Center
Bob Wilson Memorial Hospital
Hamilton County Hospital
Hodgeman County Health Center
Kearny County Hospital
Lane County Hospital
Meade District Hospital/Artesian Valley Health System
Minneola Healthcare
Morton County Health System
Satanta District Hospital, Clinics & LTCU
Scott County Hospital
Southwest Medical Center
St. Catherine Hospital Dodge City
St. Catherine Hospital Garden City
Stanton County Hospital
Stevens County Hospital
Wichita County Health Center

And thinking about your primary healthcare services provider, are they affiliated with any of the options below?

Not taking into account travel distance or time, are there any healthcare systems or healthcare providers that you would flatly reject going to if you were given the choice?