340 DOT VERSION_VH 340 DOT VERSION_VHA_Medical_Centers_Questionnaire_Templa

Customer Satisfaction Measure of Government Websites

2010 340 DOT VERSION_VHA_Medical_Centers_Questionnaire_Template.xls

CQs 7-6-2010 to 7-18-2010 DOT VERSION_VHA_Medical_Centers Hoosier Lottery (State of Indiana)

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf

Overview

Current Custom Qsts
Sheet3


Sheet 1: Current Custom Qsts

Model Instance Name: VHA Medical Centers

red & strike-through: DELETE





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 QQ






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






N/A





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






N/A





EDO03881 I Which Medical Center in Delaware do you visit? Wilmington - Wilmington VA Medical Center
Radio button, one-up vertical






N/A





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






N/A





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






N/A





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






N/A





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






N/A





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






N/A





EDO03902 DD Which Medical Center in Nebraska do you visit? Omaha - VA Nebraska-Western Iowa Health Care System
Radio button, one-up vertical






N/A





EDO03903 EE Which Medical Center in New Hampshire do you visit? Manchester - Manchester VA Medical Center
Radio button, one-up vertical






N/A





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






N/A





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






N/A





EDO03913 OO Which Medical Center in Rhode Island do you visit? Providence - Providence VA Medical Center
Radio button, one-up vertical






N/A





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 QQ 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






N/A





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






N/A





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) Facebook
Checkbox, one-up vertical Multi Y
Social media



MySpace








LinkedIn








Twitter








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



Email








Social Networking (Facebook, Twitter, etc.)








RSS








SMS / Text Messaging






Sheet 2: Sheet3

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


-
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


-
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


-
OK
Muskogee - Jack C. Montgomery VA Medical Center
OK
Oklahoma City - Oklahoma City VA Medical Center


-
OR
Roseburg - VA Roseburg Healthcare System
OR
Portland - Portland VA Medical Center


-
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


-
PR
San Juan - VA Caribbean Healthcare System


-
RI
Providence - Providence VA Medical Center


-
SC
Charleston - Ralph H. Johnson VA Medical Center
SC
Columbia - Wm. Jennings Bryan Dorn VA Medical Center


-
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


-
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


-
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


-
UT
Salt Lake City - VA Salt Lake City Health Care System


-
VA
Hampton - Hampton VA Medical Center
VA
Richmond - Hunter Holmes McGuire VA Medical Center
VA
Salem - Salem VA Medical Center


-
VT
White River Junction - White River Junction VA Medical Center


-
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


-
WI
Madison - William S. Middleton Memorial Veterans Hospital
WI
Milwaukee - Clement J. Zablocki Veterans Affairs Medical Center
WI
Tomah - Tomah VA Medical Center


-
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


-
WY
Cheyenne - Cheyenne VA Medical Center
WY
Sheridan - Sheridan VA Medical Center
File Typeapplication/vnd.ms-excel
File TitleQuestionnaire Production Guidelines_Template
AuthorProfessional Services
Last Modified Byedwin.oslan
File Modified2010-07-09
File Created2001-08-03

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