Model Instance Name: VHA Medical Centers | ||||||||||
underlined & italicized: RE-ORDER | ||||||||||
MID: 4E989k41otEAc5w1UI9opw== | pink: ADDITION | |||||||||
blue + -->: REWORDING | ||||||||||
CUSTOM QUESTION LIST | ||||||||||
QID (Group ID) |
Skip Logic Label | Question Text | Answer Choices (limited to 50 characters) |
Skip to | Type (select from list) | Single or Multi | Required Y/N |
Special Instructions | CQ Label | |
EDO03866 | How frequently do you visit this site? | First time | Radio button, one-up vertical | Single | Y | |||||
Frequently (about once a month or more often) | ||||||||||
Infrequently (Every few months or less often) | ||||||||||
EDO03867 | Please tell us who you are. | Veteran | B | Radio button, one-up vertical | Single | Y | Role | |||
Active Duty | B | |||||||||
Family Member / Friend | ||||||||||
VA Employee | ||||||||||
Volunteer | ||||||||||
Healthcare Professional (MD, RN, etc.) | ||||||||||
Job Applicant | ||||||||||
Student / Healthcare Trainee | ||||||||||
Media | ||||||||||
Other, please specify: | A | |||||||||
EDO03868 | A | Other, please specify: | Text area, no char limit | OE_Role | ||||||
EDO03869 | B | Please check the conflict(s) in which you served. | World War II | Checkbox, one-up vertical | Multi | Y | Conflict | |||
Korean Conflict | ||||||||||
Vietnam Era | ||||||||||
Persian Gulf War | ||||||||||
Operation Enduring Freedom | ||||||||||
Operation Iraqi Freedom | ||||||||||
No conflict / war service | ||||||||||
EDO03870 | Please select your age range: | 17 or under | Radio button, one-up vertical | Single | Y | Age | ||||
18-24 | ||||||||||
25-34 | ||||||||||
35-44 | ||||||||||
45-54 | ||||||||||
55-64 | ||||||||||
65+ | ||||||||||
Prefer not to answer | ||||||||||
EDO03871 | Please select your gender: | Male | Radio button, one-up vertical | Single | Y | Age | ||||
Female | ||||||||||
Prefer not to answer | ||||||||||
EDO03872 | From which medical center do you get the majority of your care? (Choose State First) (If you receive most of your care at a community-based outpatient clinic, please select the medical center from which you would receive advanced care if needed). |
Do not have a primary medical center | Drop down, select one | Single | Y | State | ||||
Alaska | A | |||||||||
Alabama | B | |||||||||
Arkansas | C | |||||||||
Arizona | D | |||||||||
California | E | |||||||||
Colorado | F | |||||||||
Connecticut | G | |||||||||
District of Columbia | H | |||||||||
Delaware | I | |||||||||
Florida | J | |||||||||
Georgia | K | |||||||||
Hawaii | L | |||||||||
Iowa | M | |||||||||
Idaho | N | |||||||||
Illinois | O | |||||||||
Indiana | P | |||||||||
Kansas | Q | |||||||||
Kentucky | R | |||||||||
Louisiana | S | |||||||||
Massachusetts | T | |||||||||
Maryland | U | |||||||||
Maine | V | |||||||||
Michigan | W | |||||||||
Minnesota | X | |||||||||
Missouri | Y | |||||||||
Mississippi | Z | |||||||||
Montana | AA | |||||||||
North Carolina | BB | |||||||||
North Dakota | CC | |||||||||
Nebraska | DD | |||||||||
New Hampshire | EE | |||||||||
New Jersey | FF | |||||||||
New Mexico | GG | |||||||||
Nevada | HH | |||||||||
New York | II | |||||||||
Ohio | JJ | |||||||||
Oklahoma | KK | |||||||||
Oregon | LL | |||||||||
Pennsylvania | MM | |||||||||
Puerto Rico | NN | |||||||||
Rhode Island | OO | |||||||||
South Carolina | PP | |||||||||
South Dakota | ||||||||||
Tennessee | RR | |||||||||
Texas | SS | |||||||||
Utah | TT | |||||||||
Virginia | UU | |||||||||
Vermont | VV | |||||||||
Washington | WW | |||||||||
Wisconsin | XX | |||||||||
West Virginia | YY | |||||||||
Wyoming | ZZ | |||||||||
EDO03873 | A | Which Medical Center in Alaska do you visit? | Anchorage - Alaska VA Healthcare System | Radio button, one-up vertical | ||||||
EDO03874 | B | Which Medical Center in Alabama do you visit? | Birmingham - Birmingham VA Medical Center | Radio button, one-up vertical | ||||||
Montgomery - Central Alabama Veterans Health Care System | ||||||||||
Tuscaloosa - Tuscaloosa VA Medical Center | ||||||||||
Tuskegee - Central Alabama Veterans Health Care System | ||||||||||
EDO03875 | C | Which Medical Center in Arkansas do you visit? | Fayetteville - Veterans Health Care System of the Ozarks | Radio button, one-up vertical | ||||||
Little Rock - Central Arkansas Veterans Healthcare System | ||||||||||
North Little Rock - Central Arkansas Veterans Healthcare System | ||||||||||
EDO03876 | D | Which Medical Center in Arizona do you visit? | Phoenix - Phoenix VA Health Care System | Radio button, one-up vertical | ||||||
Prescott - Northern Arizona VA Health Care System | ||||||||||
Tucson - Southern Arizona VA Health Care System | ||||||||||
EDO03877 | E | Which Medical Center in California do you visit? | Fresno - VA Central California Health Care System | Radio button, one-up vertical | ||||||
Livermore - VA Palo Alto Health Care System | ||||||||||
Loma Linda - VA Loma Linda Healthcare System | ||||||||||
Long Beach - VA Long Beach Healthcare System | ||||||||||
Los Angeles - VA Greater Los Angeles Healthcare System | ||||||||||
Mather - VA Northern California Health Care System | ||||||||||
Menlo Park - VA Palo Alto Health Care System | ||||||||||
Palo Alto - VA Palo Alto Health Care System | ||||||||||
San Diego - VA San Diego Healthcare System | ||||||||||
San Francisco - San Francisco VA Medical Center | ||||||||||
EDO03878 | F | Which Medical Center in Colorado do you visit? | Denver - VA Eastern Colorado Health Care System | Radio button, one-up vertical | ||||||
Grand Junction - Grand Junction VA Medical Center | ||||||||||
EDO03879 | G | Which Medical Center in Connecticut do you visit? | Newington - VA Connecticut Healthcare System | Radio button, one-up vertical | ||||||
West Haven - VA Connecticut Healthcare System | ||||||||||
EDO03880 | H | Which Medical Center in District of Columbia do you visit? | Washington DC - Washington DC VA Medical Center | Radio button, one-up vertical | ||||||
EDO03881 | I | Which Medical Center in Delaware do you visit? | Wilmington - Wilmington VA Medical Center | Radio button, one-up vertical | ||||||
EDO03882 | J | Which Medical Center in Florida do you visit? | Bay Pines - Bay Pines VA Healthcare System | Radio button, one-up vertical | ||||||
Miami - Miami VA Healthcare System | ||||||||||
Gainesville - North Florida / South Georgia VA Healthcare System | ||||||||||
Lake City - North Florida / South Georgia VA Healthcare System | ||||||||||
Orlando - Orlando VA Medical Center | ||||||||||
Tampa - James A. Haley Veterans' Hospital | ||||||||||
West Palm Beach - West Palm Beach VA Medical Center | ||||||||||
EDO03883 | K | Which Medical Center in Georgia do you visit? | Augusta - Charlie Norwood VA Medical Center | Radio button, one-up vertical | ||||||
Decatur - Atlanta VA Medical Center | ||||||||||
Dublin - Carl Vinson VA Medical Center | ||||||||||
EDO03884 | L | Which Medical Center in Hawaii do you visit? | Honolulu - VA Pacific Islands Health Care System | Radio button, one-up vertical | ||||||
EDO03885 | M | Which Medical Center in Iowa do you visit? | Des Moines - VA Central Iowa Health Care System | Radio button, one-up vertical | ||||||
Iowa City - Iowa City VA Medical Center | ||||||||||
EDO03886 | N | Which Medical Center in Idaho do you visit? | Boise VA Medical Center | Radio button, one-up vertical | ||||||
EDO03887 | O | Which Medical Center in Illinois do you visit? | Chicago - Jesse Brown VA Medical Center | Radio button, one-up vertical | ||||||
Danville - VA Illiana Health Care System | ||||||||||
Hines - Edward Hines Jr. VA Hospital | ||||||||||
Marion - Marion VA Medical Center | ||||||||||
North Chicago - North Chicago VA Medical Center | ||||||||||
EDO03888 | P | Which Medical Center in Indiana do you visit? | Fort Wayne - VA Northern Indiana Health Care System | Radio button, one-up vertical | ||||||
Indianapolis - Richard L. Roudebush VA Medical Center | ||||||||||
Marion - VA Northern Indiana Health Care System | ||||||||||
EDO03889 | Q | Which Medical Center in Kansas do you visit? | Leavenworth - VA Eastern Kansas Health Care System | Radio button, one-up vertical | ||||||
Topeka - VA Eastern Kansas Health Care System | ||||||||||
Wichita - Robert J. Dole VA Medical Center | ||||||||||
EDO03890 | R | Which Medical Center in Kentucky do you visit? | Lexington - Lexington VA Medical Center (Cooper Division) | Radio button, one-up vertical | ||||||
Lexington - Lexington VA Medical Center (Leestown Division) | ||||||||||
Louisville - Louisville VA Medical Center | ||||||||||
EDO03891 | S | Which Medical Center in Lousiana do you visit? | New Orleans - Southeast Louisiana Veterans Health Care System | Radio button, one-up vertical | ||||||
Pineville - Alexandria VA Medical Center | ||||||||||
Shreveport - Overton Brooks VA Medical Center | ||||||||||
EDO03892 | T | Which Medical Center in Massachusetts do you visit? | Bedford - Edith Nourse Rogers Memorial Veterans Hospital | Radio button, one-up vertical | ||||||
Brockton - VA Boston Healthcare System | ||||||||||
Jamaica Plain - VA Boston Healthcare System | ||||||||||
Leeds - Northampton VA Medical Center | ||||||||||
West Roxbury - VA Boston Healthcare System | ||||||||||
EDO03893 | U | Which Medical Center in Maryland do you visit? | Baltimore - VA Maryland Health Care System | Radio button, one-up vertical | ||||||
Perry Point - Perry Point VA Medical Center | ||||||||||
EDO03894 | V | Which Medical Center in Maine do you visit? | Augusta - Togus VA Medical Center | Radio button, one-up vertical | ||||||
EDO03895 | W | Which Medical Center in Michigan do you visit? | Ann Arbor - VA Ann Arbor Healthcare System | Radio button, one-up vertical | ||||||
Battle Creek - Battle Creek VA Medical Center | ||||||||||
Detroit - John D. Dingell VA Medical Center | ||||||||||
Iron Mountain - Oscar G. Johnson VA Medical Center | ||||||||||
Saginaw - Aleda E. Lutz VA Medical Center | ||||||||||
EDO03896 | X | Which Medical Center in Minnesota do you visit? | Minneapolis - Minneapolis VA Medical Center | Radio button, one-up vertical | ||||||
St. Cloud - St. Cloud VA Medical Center | ||||||||||
EDO03897 | Y | Which Medical Center in Missouri do you visit? | Columbia - Harry S. Truman Memorial VA Medical Center | Radio button, one-up vertical | ||||||
Kansas City - Kansas City VA Medical Center | ||||||||||
Poplar Bluff - John J. Pershing VA Medical Center | ||||||||||
St. Louis - St. Louis VA Medical Center (Jefferson Barracks Division) | ||||||||||
St. Louis - St. Louis VA Medical Center (John Cochran Division) | ||||||||||
EDO03898 | Z | Which Medical Center in Mississippi do you visit? | Biloxi - VA Gulf Coast Veterans Health Care System | Radio button, one-up vertical | ||||||
Jackson - G.V. (Sonny) Montgomery VA Medical Center | ||||||||||
EDO03899 | AA | Which Medical Center in Montana do you visit? | Fort Harrison - VA Montana Health Care System | Radio button, one-up vertical | ||||||
EDO03900 | BB | Which Medical Center in North Carolina do you visit? | Asheville - Asheville VA Medical Center | Radio button, one-up vertical | ||||||
Durham - Durham VA Medical Center | ||||||||||
Fayetteville - Fayetteville VA Medical Center | ||||||||||
Salisbury - W.G. (Bill) Hefner VA Medical Center | ||||||||||
EDO03901 | CC | Which Medical Center in North Dakota do you visit? | Fargo - Fargo VA Medical Center | Radio button, one-up vertical | ||||||
EDO03902 | DD | Which Medical Center in Nebraska do you visit? | Omaha - VA Nebraska-Western Iowa Health Care System | Radio button, one-up vertical | ||||||
EDO03903 | EE | Which Medical Center in New Hampshire do you visit? | Manchester - Manchester VA Medical Center | Radio button, one-up vertical | ||||||
EDO03904 | FF | Which Medical Center in New Jersey do you visit? | East Orange - VA New Jersey Health Care System | Radio button, one-up vertical | ||||||
Lyons - VA New Jersey Health Care System | ||||||||||
EDO03905 | GG | Which Medical Center in New Mexico do you visit? | Albuquerque - New Mexico VA Health Care System | Radio button, one-up vertical | ||||||
EDO03906 | HH | Which Medical Center in Nevada do you visit? | Las Vegas - VA Southern Nevada Healthcare System | Radio button, one-up vertical | ||||||
Reno - VA Sierra Nevada Health Care System | ||||||||||
EDO03907 | II | Which Medical Center in New York do you visit? | Albany - Samuel S. Stratton VA Medical Center | Radio button, one-up vertical | ||||||
Batavia - VA Western New York Healthcare System | ||||||||||
Bath - Bath VA Medical Center | ||||||||||
Bronx - James J. Peters VA Medical Center | ||||||||||
Brooklyn - VA NY Harbor Healthcare System | ||||||||||
Buffalo - VA Western New York Healthcare System | ||||||||||
Canandaigua - Canandaigua VA Medical Center | ||||||||||
Castle Point - VA Hudson Valley Health Care System | ||||||||||
Montrose - VA Hudson Valley Health Care System | ||||||||||
New York - VA NY Harbor Healthcare System - Manhattan Campus | ||||||||||
Northport - Northport VA Medical Center | ||||||||||
Syracuse - Syracuse VA Medical Center | ||||||||||
EDO03908 | JJ | Which Medical Center in Ohio do you visit? | Chillicothe - Chillicothe VA Medical Center | Radio button, one-up vertical | ||||||
Cincinnati - Cincinnati VA Medical Center | ||||||||||
Cleveland - Louis Stokes VA Medical Center | ||||||||||
Columbus - Chalmbers P. Wylie Ambulatory Care Center | ||||||||||
Dayton - Dayton VA Medical Center | ||||||||||
EDO03909 | KK | Which Medical Center in Oklahoma do you visit? | Muskogee - Jack C. Montgomery VA Medical Center | Radio button, one-up vertical | ||||||
Oklahoma City - Oklahoma City VA Medical Center | ||||||||||
EDO03910 | LL | Which Medical Center in Oregon do you visit? | Roseburg - VA Roseburg Healthcare System | Radio button, one-up vertical | ||||||
Portland - Portland VA Medical Center | ||||||||||
EDO03911 | MM | Which Medical Center in Pennsylvannia do you visit? | Altoona - James E. Van Zandt VA Medical Center | Radio button, one-up vertical | ||||||
Butler - VA Butler Healthcare System | ||||||||||
Coatesville - Coatesville VA Medical Center | ||||||||||
Erie - Erie VA Medical Center | ||||||||||
Lebanon - Lebanon VA Medical Center | ||||||||||
Philadelphia - Philadelphia VA Medical Center | ||||||||||
Pittsburgh - VA Pittsburgh Healthcare System (Highland Drive Division) | ||||||||||
Pittsburgh - VA Pittsburgh Healthcare System (University Drive Division) | ||||||||||
Wilkes-Barre - Wilkes-Barre VA Medical Center | ||||||||||
EDO03912 | NN | Which Medical Center in Puerto Rico do you visit? | San Juan - VA Caribbean Healthcare System | Radio button, one-up vertical | ||||||
EDO03913 | OO | Which Medical Center in Rhode Island do you visit? | Providence - Providence VA Medical Center | Radio button, one-up vertical | ||||||
EDO03914 | PP | Which Medical Center in South Carolina do you visit? | Charleston - Ralph H. Johnson VA Medical Center | Radio button, one-up vertical | ||||||
Columbia - Wm. Jennings Bryan Dorn VA Medical Center | ||||||||||
EDO03915 | Which Medical Center in South Dakota do you visit? | Fort Meade - VA Black Hills Health Care System | Radio button, one-up vertical | |||||||
Hot Springs - VA Black Hills Health Care System | ||||||||||
Sioux Falls - Sioux Falls VA Medical Center | ||||||||||
EDO03916 | RR | Which Medical Center in Tennessee do you visit? | Memphis - Memphis VA Medical Center | Radio button, one-up vertical | ||||||
Mountain Home - Mountain Home VA Medical Center | ||||||||||
Murfreesboro - Tennessee Valley Healthcare System | ||||||||||
Nashville - Tennessee Valley Healthcare System | ||||||||||
EDO03917 | SS | Which Medical Center in Texas do you visit? | Amarillo - Amarillo VA Health Care System | Radio button, one-up vertical | ||||||
Big Spring - West Texas VA Health Care System | ||||||||||
Dallas - VA North Texas Health Care System | ||||||||||
El Paso - El Paso VA Health Care System | ||||||||||
San Antonio - South Texas Veterans Health Care System | ||||||||||
Temple - Central Texas Veterans Health Care System | ||||||||||
Bonham - VA North Texas Health Care System | ||||||||||
Houston - Michael E. DeBakey VA Medical Center | ||||||||||
Kerrville - Kerrville VA Medical Center | ||||||||||
Waco - Central Texas Veterans Health Care System | ||||||||||
EDO03918 | TT | Which Medical Center in Utah do you visit? | Salt Lake City - VA Salt Lake City Health Care System | Radio button, one-up vertical | ||||||
EDO03919 | UU | Which Medical Center in Virginia do you visit? | Hampton - Hampton VA Medical Center | Radio button, one-up vertical | ||||||
Richmond - Hunter Holmes McGuire VA Medical Center | ||||||||||
Salem - Salem VA Medical Center | ||||||||||
EDO03920 | VV | Which Medical Center in Vermont do you visit? | White River Junction - White River Junction VA Medical Center | Radio button, one-up vertical | ||||||
EDO03921 | WW | Which Medical Center in Washington do you visit? | Seattle - VA Puget Sound Health Care System | Radio button, one-up vertical | ||||||
Tacoma - VA Puget Sound Health Care System (American Lake Division) | ||||||||||
Spokane - Spokane VA Medical Center | ||||||||||
Walla Walla - Jonathan M. Wainwright Memorial VA Medical Center | ||||||||||
EDO03922 | XX | Which Medical Center in Wisconsin do you visit? | Madison - William S. Middleton Memorial Veterans Hospital | Radio button, one-up vertical | ||||||
Milwaukee - Clement J. Zablocki Veterans Affairs Medical Center | ||||||||||
Tomah - Tomah VA Medical Center | ||||||||||
EDO03923 | YY | Which Medical Center in West Virginia do you visit? | Beckley - Beckley VA Medical Center | Radio button, one-up vertical | ||||||
Clarksburg - Louis A. Johnson VA Medical Center | ||||||||||
Huntington - Huntington VA Medical Center | ||||||||||
Martinsburg - Martinsburg VA Medical Center | ||||||||||
EDO03924 | ZZ | Which Medical Center in Wyoming do you visit? | Cheyenne - Cheyenne VA Medical Center | Radio button, one-up vertical | ||||||
Sheridan - Sheridan VA Medical Center | ||||||||||
EDO03925 | What type of information were you trying to find on this medical center web site? (Check all that apply) | Facility contact information | Checkbox, one-up vertical | Multi | Y | |||||
Directions / Locations | ||||||||||
Hours of Operation | ||||||||||
Services Available | ||||||||||
Make, change, or cancel an appointment | ||||||||||
Prescription refills | ||||||||||
Emergency information | ||||||||||
Jobs | ||||||||||
Volunteer Information | ||||||||||
Transportation (Rural, DAV, etc.) | ||||||||||
Family & Dependent Health Benefits | ||||||||||
Healthcare Eligibility | ||||||||||
Health Education (classes, tutorials, etc.) | ||||||||||
General Health Information | ||||||||||
Healthcare Professional Training (Students, Residents, etc.) | ||||||||||
Home Health Care | ||||||||||
Nursing Home Care | ||||||||||
Telephone Care (after hours) | ||||||||||
Other, please specify: | A | |||||||||
EDO03926 | A | Other, please specify | OE_Reason | |||||||
EDO03927 | Did you find what you were looking today? | Yes | Radio button, one-up vertical | Single | Y | Find Info | ||||
No, I was looking for: | A | |||||||||
EDO03928 | A | What specific information were you unable to find? | OE_Find | |||||||
EDO03929 | Do you use any of the following while on the Internet? (Check all that apply) | Checkbox, one-up vertical | Multi | Y | Social media | |||||
MySpace | ||||||||||
YouTube | ||||||||||
Second Life | ||||||||||
Flickr | ||||||||||
Blogs | ||||||||||
Del.icio.us | ||||||||||
Digg | ||||||||||
Podcasts | ||||||||||
Other, please specify: | A | |||||||||
EDO03930 | A | Other, please specify: | Text area, no char limit | OE_Social Media | ||||||
EDO03931 | Do you use MyHealtheVet (prescription refills, personal health record, etc.)? | Yes | A | Radio button, one-up vertical | Single | Y | MHV Usage | |||
No | B | |||||||||
EDO03939 | A | Have you completed the In-Person Authentication (IPA) which allows you to view the names of your prescriptions? | Yes | Radio button, one-up vertical | Single | Y | IPA | |||
No | ||||||||||
EDO03932 | B | Why not? | Text area, no char limit | OE_Not Use MHV | ||||||
EDO03933 | Do you believe the amount of information provided about services offered at this VA Medical Center is adequate? | Yes | Radio button, one-up vertical | Single | Y | Services Adequate | ||||
No | A | |||||||||
EDO03934 | A | Why not? | Text area, no char limit | OE_Not Adequate | ||||||
EDO03935 | Where did you first hear about this VA Medical Center web site? | During Enrollment | Radio button, one-up vertical | Single | Y | How Hear | ||||
At the Medical Center | ||||||||||
From my provider (doctor, nurse, social worker, etc.) | ||||||||||
Search Engine | ||||||||||
Social Networks (Facebook, Twitter, etc.) | ||||||||||
www.va.gov | ||||||||||
www.va.gov/health | ||||||||||
I browsed directly to the site | ||||||||||
Other, please specify: | A | |||||||||
EDO03936 | A | Other, please specify: | OE_How Hear | |||||||
EDO03937 | Would you like to see additional information about recent news & events at this medical center and its clinics? | Yes | A | Radio button, one-up vertical | Single | Y | Add Info | |||
No | ||||||||||
EDO03938 | A | How would you like to see this information? (Check all that apply) | Directly on the medical center's web site | Radio button, one-up vertical | Single | Y | How Add Info | |||
Social Networking (Facebook, Twitter, etc.) | ||||||||||
RSS | ||||||||||
SMS / Text Messaging |
AK | Anchorage - Alaska VA Healthcare System | |
AL | Birmingham - Birmingham VA Medical Center | |
AL | Montgomery - Central Alabama Veterans Health Care System | |
AL | Tuscaloosa - Tuscaloosa VA Medical Center | |
AL | Tuskegee - Central Alabama Veterans Health Care System | |
AR | Fayetteville - Veterans Health Care System of the Ozarks | |
AR | Little Rock - Central Arkansas Veterans Healthcare System | |
AR | North Little Rock - Central Arkansas Veterans Healthcare System | |
AZ | Phoenix - Phoenix VA Health Care System | |
AZ | Prescott - Northern Arizona VA Health Care System | |
AZ | Tucson - Southern Arizona VA Health Care System | |
- | ||
CA | Fresno - VA Central California Health Care System | |
CA | Livermore - VA Palo Alto Health Care System | |
CA | Loma Linda - VA Loma Linda Healthcare System | |
CA | Long Beach - VA Long Beach Healthcare System | |
CA | Los Angeles - VA Greater Los Angeles Healthcare System | |
CA | Mather - VA Northern California Health Care System | |
CA | Menlo Park - VA Palo Alto Health Care System | |
CA | Palo Alto - VA Palo Alto Health Care System | |
CA | San Diego - VA San Diego Healthcare System | |
CA | San Francisco - San Francisco VA Medical Center | |
- | ||
CO | Denver - VA Eastern Colorado Health Care System | |
CO | Grand Junction - Grand Junction VA Medical Center | |
- | ||
CT | Newington - VA Connecticut Healthcare System | |
CT | West Haven - VA Connecticut Healthcare System | |
- | ||
DC | Washington DC - Washington DC VA Medical Center | |
- | ||
DE | Wilmington - Wilmington VA Medical Center | |
FL | Bay Pines - Bay Pines VA Healthcare System | |
FL | Miami - Miami VA Healthcare System | |
FL | Gainesville - North Florida / South Georgia VA Healthcare System | |
FL | Lake City - North Florida / South Georgia VA Healthcare System | |
FL | Orlando - Orlando VA Medical Center | |
FL | Tampa - James A. Haley Veterans' Hospital | |
FL | West Palm Beach - West Palm Beach VA Medical Center | |
- | ||
GA | Augusta - Charlie Norwood VA Medical Center | |
GA | Decatur - Atlanta VA Medical Center | |
GA | Dublin - Carl Vinson VA Medical Center | |
- | ||
HI | Honolulu - VA Pacific Islands Health Care System | |
- | ||
IA | Des Moines - VA Central Iowa Health Care System | |
IA | Iowa City - Iowa City VA Medical Center | |
- | ||
ID | Boise - Boise VA Medical Center | |
- | ||
IL | Chicago - Jesse Brown VA Medical Center | |
IL | Danville - VA Illiana Health Care System | |
IL | Hines - Edward Hines Jr. VA Hospital | |
IL | Marion - Marion VA Medical Center | |
IL | North Chicago - North Chicago VA Medical Center | |
- | ||
IN | Fort Wayne - VA Northern Indiana Health Care System | |
IN | Indianapolis - Richard L. Roudebush VA Medical Center | |
IN | Marion - VA Northern Indiana Health Care System | |
- | ||
KS | Leavenworth - VA Eastern Kansas Health Care System | |
KS | Topeka - VA Eastern Kansas Health Care System | |
KS | Wichita - Robert J. Dole VA Medical Center | |
- | ||
KY | Lexington - Lexington VA Medical Center (Cooper Division) | |
KY | Lexington - Lexington VA Medical Center (Leestown Division) | |
KY | Louisville - Louisville VA Medical Center | |
- | ||
LA | New Orleans - Southeast Louisiana Veterans Health Care System | |
LA | Pineville - Alexandria VA Medical Center | |
LA | Shreveport - Overton Brooks VA Medical Center | |
- | ||
MA | Bedford - Edith Nourse Rogers Memorial Veterans Hospital | |
MA | Brockton - VA Boston Healthcare System | |
MA | Jamaica Plain - VA Boston Healthcare System | |
MA | Leeds - Northampton VA Medical Center | |
MA | West Roxbury - VA Boston Healthcare System | |
- | ||
MD | Baltimore - VA Maryland Health Care System | |
MD | Perry Point - Perry Point VA Medical Center | |
- | ||
ME | Augusta - Togus VA Medical Center | |
- | ||
MI | Ann Arbor - VA Ann Arbor Healthcare System | |
MI | Battle Creek - Battle Creek VA Medical Center | |
MI | Detroit - John D. Dingell VA Medical Center | |
MI | Iron Mountain - Oscar G. Johnson VA Medical Center | |
MI | Saginaw - Aleda E. Lutz VA Medical Center | |
- | ||
MN | Minneapolis - Minneapolis VA Medical Center | |
MN | St. Cloud - St. Cloud VA Medical Center | |
- | ||
MO | Columbia - Harry S. Truman Memorial VA Medical Center | |
MO | Kansas City - Kansas City VA Medical Center | |
MO | Poplar Bluff - John J. Pershing VA Medical Center | |
MO | St. Louis - St. Louis VA Medical Center (Jefferson Barracks Division) | |
MO | St. Louis - St. Louis VA Medical Center (John Cochran Division) | |
- | ||
MS | Biloxi - VA Gulf Coast Veterans Health Care System | |
MS | Jackson - G.V. (Sonny) Montgomery VA Medical Center | |
- | ||
MT | Fort Harrison - VA Montana Health Care System | |
- | ||
NC | Asheville - Asheville VA Medical Center | |
NC | Durham - Durham VA Medical Center | |
NC | Fayetteville - Fayetteville VA Medical Center | |
NC | Salisbury - W.G. (Bill) Hefner VA Medical Center | |
- | ||
ND | Fargo - Fargo VA Medical Center | |
- | ||
NE | Omaha - VA Nebraska-Western Iowa Health Care System | |
- | ||
NH | Manchester - Manchester VA Medical Center | |
- | ||
NJ | East Orange - VA New Jersey Health Care System | |
NJ | Lyons - VA New Jersey Health Care System | |
- | ||
NM | Albuquerque - New Mexico VA Health Care System | |
- | ||
NV | Las Vegas - VA Southern Nevada Healthcare System | |
NV | Reno - VA Sierra Nevada Health Care System | |
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NY | Albany - Samuel S. Stratton VA Medical Center | |
NY | Batavia - VA Western New York Healthcare System | |
NY | Bath - Bath VA Medical Center | |
NY | Bronx - James J. Peters VA Medical Center | |
NY | Brooklyn - VA NY Harbor Healthcare System | |
NY | Buffalo - VA Western New York Healthcare System | |
NY | Canandaigua - Canandaigua VA Medical Center | |
NY | Castle Point - VA Hudson Valley Health Care System | |
NY | Montrose - VA Hudson Valley Health Care System | |
NY | New York - VA NY Harbor Healthcare System - Manhattan Campus | |
NY | Northport - Northport VA Medical Center | |
NY | Syracuse - Syracuse VA Medical Center | |
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OH | Chillicothe - Chillicothe VA Medical Center | |
OH | Cincinnati - Cincinnati VA Medical Center | |
OH | Cleveland - Louis Stokes VA Medical Center | |
OH | Columbus - Chalmbers P. Wylie Ambulatory Care Center | |
OH | Dayton - Dayton VA Medical Center | |
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OK | Muskogee - Jack C. Montgomery VA Medical Center | |
OK | Oklahoma City - Oklahoma City VA Medical Center | |
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OR | Roseburg - VA Roseburg Healthcare System | |
OR | Portland - Portland VA Medical Center | |
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PA | Altoona - James E. Van Zandt VA Medical Center | |
PA | Butler - VA Butler Healthcare System | |
PA | Coatesville - Coatesville VA Medical Center | |
PA | Erie - Erie VA Medical Center | |
PA | Lebanon - Lebanon VA Medical Center | |
PA | Philadelphia - Philadelphia VA Medical Center | |
PA | Pittsburgh - VA Pittsburgh Healthcare System (Highland Drive Division) | |
PA | Pittsburgh - VA Pittsburgh Healthcare System (University Drive Division) | |
PA | Wilkes-Barre - Wilkes-Barre VA Medical Center | |
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PR | San Juan - VA Caribbean Healthcare System | |
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RI | Providence - Providence VA Medical Center | |
- | ||
SC | Charleston - Ralph H. Johnson VA Medical Center | |
SC | Columbia - Wm. Jennings Bryan Dorn VA Medical Center | |
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SD | Fort Meade - VA Black Hills Health Care System | |
SD | Hot Springs - VA Black Hills Health Care System | |
SD | Sioux Falls - Sioux Falls VA Medical Center | |
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TN | Memphis - Memphis VA Medical Center | |
TN | Mountain Home - Mountain Home VA Medical Center | |
TN | Murfreesboro - Tennessee Valley Healthcare System | |
TN | Nashville - Tennessee Valley Healthcare System | |
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TX | Amarillo - Amarillo VA Health Care System | |
TX | Big Spring - West Texas VA Health Care System | |
TX | Dallas - VA North Texas Health Care System | |
TX | El Paso - El Paso VA Health Care System | |
TX | San Antonio - South Texas Veterans Health Care System | |
TX | Temple - Central Texas Veterans Health Care System | |
TX | Bonham - VA North Texas Health Care System | |
TX | Houston - Michael E. DeBakey VA Medical Center | |
TX | Kerrville - Kerrville VA Medical Center | |
TX | Waco - Central Texas Veterans Health Care System | |
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UT | Salt Lake City - VA Salt Lake City Health Care System | |
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VA | Hampton - Hampton VA Medical Center | |
VA | Richmond - Hunter Holmes McGuire VA Medical Center | |
VA | Salem - Salem VA Medical Center | |
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VT | White River Junction - White River Junction VA Medical Center | |
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WA | Seattle - VA Puget Sound Health Care System | |
WA | Tacoma - VA Puget Sound Health Care System (American Lake Division) | |
WA | Spokane - Spokane VA Medical Center | |
WA | Walla Walla - Jonathan M. Wainwright Memorial VA Medical Center | |
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WI | Madison - William S. Middleton Memorial Veterans Hospital | |
WI | Milwaukee - Clement J. Zablocki Veterans Affairs Medical Center | |
WI | Tomah - Tomah VA Medical Center | |
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WV | Beckley - Beckley VA Medical Center | |
WV | Clarksburg - Louis A. Johnson VA Medical Center | |
WV | Huntington - Huntington VA Medical Center | |
WV | Martinsburg - Martinsburg VA Medical Center | |
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WY | Cheyenne - Cheyenne VA Medical Center | |
WY | Sheridan - Sheridan VA Medical Center |
File Type | application/vnd.ms-excel |
File Title | Questionnaire Production Guidelines_Template |
Author | Professional Services |
Last Modified By | edwin.oslan |
File Modified | 2010-07-09 |
File Created | 2001-08-03 |