HRSA BCRS NHSC Satisfaction Questionnaire
Health Resources and Services Administration Bureau of Clinician Recruitment and Service
Survey to be administered via the Web. Instructions and headings in BOLD and question numbers will not be seen by the respondents.
The National Health Service Corps (NHSC) is committed to continuous performance improvement. As part of this effort, we are requesting feedback on your experiences with the NHSC.
The survey is hosted via a secure server and your responses will remain anonymous. This survey is authorized by Office of Management and Budget Control No. 1090-0007 (expires March 31, 2015).
The survey will take approximately 15 minutes to complete. Thank you in advance for completing the survey.
Please click on the “Next” button below to begin.
INTRO1. Through which program did you join the National Health Service Corps? (Select one)
NHSC Scholarship Program
NHSC Loan Repayment Program
NHSC Students to Service Loan Repayment Program
None of the above (TERMINATE)
INTRO2. Are you currently in school or residency?
Yes - (Will be defined as Group 3 – current students) [Skip Retention section]
No
INTRO2a. [IF INTRO 2=NO] How long did it take you to find employment?
1-6 months
7-12 months
More than 1 year
INTRO3a. Please select your discipline type (select one)
Primary Care
Oral Health
Mental/Behavioral Health
INTRO3b. Please select your discipline from the list below. (Select one) [Limit response options based on answer to INTRO3a.)
Physician (MD, DO) (filter for PC)
Psychiatrist (filter M/BH)
Physician Assistant (filter for PC)
Nurse Practitioner (filter for PC)
Certified Nurse Midwife (filter for PC)
Psychiatric Nurse Specialist (filter M/BH)
Dentist (DDS, DMD) (filter OH)
Dental Hygienist (filter OH)
Health Service Clinical Psychologist (filter M/BH)
Licensed Clinical Social Worker (filter M/BH)
Licensed Professional Counselor (filter M/BH)
Marriage and Family Therapist (filter M/BH)
RET1. Did you complete your service obligation prior to October 1, 2013?
Yes (Will be defined as Group 2 –not actively serving) (Continue)
No (Will be defined as Group 1 – current and actively serving) (SKIP TO RET19)
RET2 . When did you complete your service obligation with the NHSC?
[NOTE: Drop down box for month and year selection]
RET3. Are you still providing direct patient care at the NHSC site where you completed your NHSC service obligation?
Yes
No
RET4. (ONLY IF RET3=1) How did you become aware of the job you currently hold?
NHSC Regional Office
NHSC Jobs Center (online job search tool launched in 2012)
NHSC Job Opportunities website
Internet search
Outside Recruiter
Current employee at the site
Friend or family member
School or clinical rotation/residency program
State recruitment web site
State Primary Care Office
State Primary Care Association
Other, please specify
RET5. (ONLY IF RET3 =2) How did you become aware of the job where you completed your service obligation?
NHSC Regional Office
NHSC Jobs Center (online job search tool launched in 2012)
Internet search
Outside Recruiter
Current employee at the site
Friend or family member
School or clinical rotation/residency program
State recruitment web site
State Primary Care Office
State Primary Care Association
Other, please specify
RET5a. (ONLY IF RET5=Internet Search) Please specify which websites you visited for your internet search.
RET6. Were you employed at your site prior to applying to the NHSC Loan Repayment Program?
Yes
No (If RET3 = YES, SKIP to RET8; If RET3=NO, SKIP to RET9)
RET7. (ONLY IF RET6=1) How long were you employed at your site prior to applying to the NHSC Loan Repayment Program?
Less than 1 year
1-2 years
2-5 years
More than 5 years
RET8. How long do you plan to remain at this site?
Less than 1 year
1-2 years
2-5 years
More than 5 years
RET 9. Did the opportunity to apply for NHSC Loan Repayment influence your decision to choose your site?
Yes
No
RET10. [ONLY IF RET3=YES] What influenced your decision to remain at the site? [Select all that apply.]
Salary
Opportunities for advancement
Cost of living
Experience at site
Site operation/direction closely aligned with my personal goals
Balanced schedule/hours
Use of electronic health record system
Use of telemedicine
Availability of distance learning opportunities
Availability of resources to do my job well
Community support
Close to extended family/parents and siblings
Family wanted to stay in community
Spouse employment opportunities
School district
Other, please specify
RET11. [ONLY IF RET3=NO] What was the main reason for deciding to leave this site?
Financial considerations
Lack of opportunity for advancement
Lack of distance learning opportunities
Lack of resources to do my job well
Site operation/direction did not align with personal goals
Problems with employer/site
Didn’t like the community and/or lifestyle
Long hours/no “work/life” balance
Family considerations
Change of career
Retirement
Other, please specify
RET12. [If RET3=NO] Part of the National Health Service Corps’ mission is to provide access to quality care for the Nation’s most vulnerable. Have you chosen to continue to provide care to underserved populations in the same geographic area where you completed your service obligation?
Yes
No
RET13. [IF RET12=YES] How long do you plan to remain in this community/geographic area?
Less than 1 year
1-2 years
2-5 years
More than 5 years
RET14. [IF RET3=NO] Have you chosen to provide direct patient care at another NHSC-approved site after fulfilling your service obligation?
Yes
No
Don’t know if site is NHSC-approved
RET15. [ONLY IF RET14=YES] How long have you been practicing at your current NHSC-approved site?
Less than 1 year
1-2 years
2-5 years
More than 5 years
RET16. [ONLY IF RET14=NO/DON’T KNOW] Have you chosen to provide direct patient care in a health professional shortage designation (i.e., underserved community) after fulfilling your NHSC service obligation?
Yes
No
RET17. [ONLY IF RET16=YES] How long have you been practicing in this health professional shortage designation area (i.e., underserved community)?
Less than 1 year
1-2 years
2-5 years
More than 5 years
RET18. [ONLY IF RET16=NO] What was the main reason for not practicing in a health professional shortage area (i.e., underserved community)?
Financial considerations
Lack of opportunity for advancement
Lack of distance learning opportunities
Lack of resources to do my job well
Site operation/direction did not align with personal goals
Problems with employer/site
Didn’t like the community and/or lifestyle
Long hours/no balance of personal and professional life
Family considerations
Change of career
Other, please specify
RET19. [ASK ONLY OF GROUP 1 RESPONDENTS] Do you plan to remain at your current site after you have fulfilled your NHSC service obligation?
Yes
No
Don’t know (SKIP to RET24)
RET20. [ONLY IF RET19=YES] How long do you plan to remain at your current site after you have fulfilled your NHSC service obligation?
Less than 1 year
1-2 years
2-5 years
More than 5 years
RET21. [ONLY IF RET19=NO] What might influence your decision to leave your current site after you have fulfilled your NHSC service obligation?
Financial considerations
Lack of opportunity for advancement
Lack of distance learning opportunities
Lack of resources to do my job well
Site operation/direction did not align with personal goals
Problems with employer/site
Didn’t like the community and/or lifestyle
Long hours/no balance of personal and professional life
Family considerations
Retirement
Change of career
Other, please specify
RET 22. [If RET19=NO] Part of the National Health Service Corps’ mission is to provide access to quality care for the Nation’s most vulnerable. Do you think you will continue to provide care to underserved populations in the same geographic area where you completed your service obligation?
Yes
No [Skip to RET24]
RET 23. [IF RET22=1] How long do you plan to remain in this community/geographic area?
Less than 1 year
1-2 years
2-5 years
More than 5 years
RET24. [ASK ONLY OF GROUP 1 RESPONDENTS] Were you employed at your current site prior to applying to the NHSC Loan Repayment Program?
Yes
No [Skip to RET26]
RET25. [If RET24=YES] How long were you at your current site before you applied to the NHSC Loan Repayment Program?
Less than 1 year
1-2years
2-5 years
More than 5 years
RET26. [ASK ONLY OF GROUP 1 RESPONDENTS] Did the opportunity to apply to the NHSC Loan Repayment Program influence your decision to choose to work at your site?
Yes
No
RET27. (If RET19=YES) [ASK ONLY OF GROUP 1 RESPONDENTS]What will most influence your decision to remain at the site? (Select one)
Availability of loan repayment financial support
Salary
Opportunities for advancement
Cost of living
Experience at site
Site operation/direction closely aligned with my personal goals
Balanced schedule/hours
Use of electronic health record system
Use of telemedicine
Availability of distance learning opportunities
Availability of resources to do my job well
Community support
Close to extended family/parents and siblings
Family wanted to stay in community
Spouse employment opportunities
School district
Other, please specify
RET28. [ASK ONLY OF GROUP 1 RESPONDENTS] How did you become aware of the job you currently hold?
NHSC Jobs Center (online job search tool launched in 2012)
Virtual Job Fair (online job fair using webinar technology)
Internet Search
Outside Recruiter
Employee at the site
Friend of family member
School or clinical rotation/residency program
State recruitment web site
NHSC Regional Office
State Primary Care Office
State Primary Care Association
Other, please specify
RET28a. (ONLY IF RET28=Internet Search) Please specify which websites you visited for your internet search.
RET29. [ASK ONLY OF GROUP 1 RESPONDENTS] Please rank the following factors in order of their likelihood to influence your decision to continue providing health services in health professional shortage areas (i.e., underserved community) after your service obligation is complete? (Rank in order: 1=Most influence, 11=Least influence) [Randomize response options]
Relationship with current employer
Commitment to underserved communities
Current site experience
Becoming part of the community; able to put down “roots”
Corps membership benefits
Sense of community within NHSC
Experience with NHSC
Salary
Mentoring
Limited employment opportunities
Other (please specify)
How did you first hear about the NHSC program? (Select one)
Site Administrator or Site Staff
Faculty of your training programs
Colleague
Current employer
Family member or friend
Outside Recruiter
Current NHSC Member
NHSC alumnus
NHSC Website
NHSC Literature
NHSC Staff (Regional Office/Headquarters)
Internet search
Professional Association
Primary Care Office (PCO)
Primary Care Association (PCA)
Social Media (e.g., Facebook, etc.)
Exhibit at a professional meeting
Career Counselor
Other (please specify)
Q1_1a. (ONLY IF Q1_1=Internet Search) Please specify which websites you visited for your internet search.
Please think about your most recent experience applying to the NHSC Program.
Using a scale from 1 to 10, where 1 is “Poor” and 10 is “Excellent”; please rate the application process on the following statements. If a question does not apply to you, please select: “N/A.”
Q1_2. Clarity and ease of understanding the online application
Q1_3. Clarity and ease of understanding the program guidance documents
Q1_4. Ease of getting the information required to fill out the application
Q1_5. Amount of time it took to complete the application
Q1_6. Ease of submitting the application and supporting documents electronically
Q1_7. Responsiveness of support
Q1_8. Sufficiency of support
Q1_9. Timeliness of award notification
Q1_10. Ease of understanding the terms and conditions of acceptance
The NHSC Students to Service Loan Repayment Program application to which you applied opened in the fall of your 4th year of medical school. Using a scale from 1 to 10, where 1 is “Poor” and 10 is Excellent”, please rate the following statements:
Q1_11. Overall timing of application cycle [only if response to INTRO 1=3 and respondent is in Group 3]
Q1_12. Ease of acquiring loan documentation for your application [only if response to INTRO 1=3 and respondent is in Group 3]
Q1_13. Ease of acquiring letters of recommendation for your application [only if response to INTRO 1=3 and respondent is in Group 3]
Q1_14. Please use this space for any additional information you would like to provide the NHSC regarding your experience with applying to the Students-to-Service program. [only if response to INTRO 1=3 and respondent is in Group 3]
Have you used the Customer Service Portal in the last 12 months? The Customer Service Portal is a secured online account where NHSC members can conduct transactions, upload required documents, ask questions, and perform other online activities.
Yes
No (Skip to Q3_1)
Don’t know (Skip to Q3_1)
How have you used the Customer Service Portal in the last 12 months? (Select all that apply) [Limit response options based on Group]
In-school verification [Group 3]
Ask a question about my service obligation [all]
Update my personal information [all]
Look at my service obligation end date [all]
Access my continuation application information [Group 1]
Request a transfer to a new site [Group 1]
Maternity/Paternity/Adoption leave request [Group 1]
Medical or non-medical suspension [Group 1]
Request a conversion from full-time to half-time service [Group 1]
Report unemployment [Group 1]
Request assistance to find a new NHSC site [Group 1]
Complete in-service verification [Group 1]
Post Graduate Training request [Group 3]
Site Visit Request [Group 3]
Relocation Request [Group 3]
Finance Request [Group 1]
View payment history [all]
Void payment schedules [Group 1, Group 3]
Request leave of absence (personal/family/medical reasons) [Group 3]
Update contact information [all]
Update banking information [Group 1 and Group 3]
Site Search [Group 3]
View contact information for Site Search Support Advisor [Group 3]
Select state preferences to complete service obligation [Group 3]
Add initial site assignment [Group 3]
Other, please specify [all]
What additional feature, if any, would you like to see added to the Customer Service Portal? (Capture open-ended response)
Please think about your overall experience using the Customer Service Portal in the last 12 months. Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate.
The ease of navigation
Ability to find the information needed
Your ease of understanding the information communicated
The organization of the information provided
The usefulness of conducting business through the NHSC Customer Service Portal
The timeliness of NHSC Responses
Which of the following NHSC communications have you accessed in the last 12 months? (Select all that apply)
E-mail delivered via the Customer Service Portal
Customer Service Portal inquiries
Emails or e-blasts from NHSC
NHSC Facebook page
NHSC Twitter account
Other, please specify
Which do you access most often? (Select one) [Filter responses based on selections in Q3_1]
E-mail delivered via the Customer Service Portal
Customer Service Portal inquiries
Emails or e-blasts from NHSC
NHSC Facebook page
NHSC Twitter account
Other, please specify
For the method you use most often, which device did you use? (Select one)
Computer/laptop
Tablet/notebook
Smart phone
Other, please specify
Thinking about the method you use most often to access NHSC communications, and using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate…
The timeliness of the communications
The relevance of the information provided to your inquiry
Received enough detail to meet your needs
Your ease of understanding the information communicated
The organization of the information provided
The helpfulness of information in guiding your decision-making
The frequency of receiving information
How would you prefer to receive future communications from the NHSC? (Select all that apply)
E-mail delivered via the Customer Service Portal
Customer Service Portal inquiries
Emails or e-blasts from NHSC
NHSC Facebook page
NHSC Twitter account
Other, please specify
How would you prefer to receive time sensitive communications from the NHSC? (Select one)
E-mails delivered via the Customer Service Portal (Groups 1,2,& 3)
Customer Service Portal inquiries
Emails or e-blasts from NHSC (Groups 1,2,& 3)
NHSC Facebook page (Groups 1,2,& 3)
NHSC Twitter account (Groups 1,2,& 3)
Text message (Group 3)
Other, please specify (Groups 1,2,& 3)
In the past 12 months, how often did you receive communications from NHSC?
Weekly
Monthly
Quarterly
Twice per year
Yearly
In the past 12 months, how would you rate the frequency of communications received from NHSC?
Too frequent
Just right
Not frequent enough
How often would you like to receive communications from the NHSC?
More often than once per month
Monthly
Quarterly
Twice per year
Yearly or less often
In the past 12 months, which resource and/or event do you consider to be the most beneficial in keeping you up to date on NHSC activities/events? (Select one)
NHSC website
NHSC Corps Connections newsletter (monthly online newsletter)
Fact sheets related to NHSC programs and services
NHSC Facebook posts
NHSC tweets (Twitter)
Other, please specify
(Group 1 and 3 ONLY) In the past 12 months, which resource and/or event do you consider to be the most beneficial in keeping you up to date on programmatic requirements? Examples of programmatic requirements include items in-service verifications, or continuations. (Select one)
NHSC website
NHSC Corps Connections newsletter (monthly online newsletter)
NHSC Scholar Reference Guide (released annually)
NHSC Facebook post
NHSC tweets (Twitter)
NHSC educational videos
Educational webinars hosted by the NHSC
Technical assistance conference calls hosted by the NHSC
Fact sheets related to NHSC programs and services
E-mails from the Customer Service Portal
Other, please specify
(ONLY for Group 3) Is there any other information that the NHSC should consider providing to help you with your transition from training to service?
(Only for Group 1 who entered the program as an NHSC Scholar and are currently “in-service” –i.e. completing their service obligation practicing at a site). Was there any other information that the NHSC could have provided to improve your transition from training to service?
Have you visited the NHSC website within the past 12 months?
Yes
No (skip to Q5_1)
Have you heard of the NHSC Jobs Center? The NHSC Jobs Center is an interactive online resource, launched in 2012, that allows individuals seeking job opportunities to perform customized searches across thousands of NHSC-approved sites.
Yes
No (skip to Q4_6)
(ONLY IF Q4_2=1) Have you used the NHSC Jobs Center in the past 12 months to identify possible employment opportunities?
Yes
No (skip to Q4_6)
(ONLY IF Q4_3=1) Did you find the NHSC Jobs Center useful in helping you to identify possible employment opportunities?
Yes
No
(ONLY IF Q4_4= 2) How could the NHSC Jobs Center have been more useful in helping you to identify possible employment opportunities? (Capture verbatim response)
In the past 12 months, what were you searching for when you visited the NHSC website? (Select all that apply)
Information on Continuation applications
Information on in-service compliance questions
Employment opportunities
Resource materials (e.g., fact sheets, reference guides, program guidelines)
Archived webinars
Upcoming events
NHSC Corps Connections newsletter
NHSC continuing education credit opportunities
Information on new application processes
Other, please specify
What type of information would you like to see on the NHSC website that is not currently available? (Capture verbatim response)
Please think about your overall experience while visiting the NHSC website in the past 12 months. Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate…
The ease of navigation
The usefulness of the information provided
The relevance of search results
Ability to find the information needed
Have you contacted the NHSC during the past 12 months?
Yes
No (skip to Q6_1)
In the past 12 months, through what means have you contacted the NHSC? (Select all that apply)
Telephone
Fax
Customer Service Portal
Other, please specify
Please select all the reasons that you contacted the NHSC in the past 12 months. (Limit response options by group)
General information (Groups 1 and 3)
Program requirements (Groups 1 and 3)
New application question (Groups 1 and 3)
Unemployment assistance (Group 1)
Continuation application question (Group 1)
Placement question (Group 3)
Site transfer (Group 1)
Maternity/paternity/adoption leave (Group 1)
Medical or non-medical suspension (Group 1)
Conversion to half-time service (Group 1)
Six-month verification (Group 1)
Deferment (Group 3)
Site visits (Group 3)
Relocation (Group 3)
Scholarship award (tuition, fees and stipend) (Group 3)
View payment history [Group 1, Group 3]
Void payment schedules [Group 1, Group 3]
Leave of absence request (personal/family/medical reasons) [Group 3]
Update contact information [Group 1, Group 3]
Update banking information [Group 1, Group 3]
Other (please specify) (Groups 1 and 3)
Of all the reasons you selected for contacting the NHSC in the past 12 months, what was the reason of your most recent contact? (Only show selections made in Q5_3)
General information
Program requirements
New application question
Unemployment assistance
Continuation application question
Placement question
Site transfer
Maternity/paternity/adoption leave
Medical or non-medical suspension
Conversion to half-time service
Six-month verification
Deferment
Site visits
Relocation
Scholarship award (tuition, fees and stipend)
View payment history
Void payment schedules
Leave of absence request (personal/family/medical reasons)
Update contact information
Update banking information
Other (please specify)
For your most recent contact, approximately how long did it take for the NHSC to first respond to, or acknowledge, your initial contact?
Within 24 hours
Within 48 hours
Within 3-4 days
Within 1 week
Within 1 month
Within a few months
They have never responded to my initial contact
For your most recent contact, ideally, how long should the NHSC have taken to first respond to, or acknowledge, your initial contact?
No more than 24 hours
No more than 48 hours
No more than 3-4 days
No more than 1 week
No more than 1 month
Was the NHSC representative able to resolve your issue?
Yes
No (skip to Q5_9)
How long did it take for the NHSC to resolve your issue/situation (Ask only if Q5_7=1)?
Within 24 hours
Within 48 hours
Within 3-4 days
Within 1 week
Within 1 month
Within a few months
Ideally, what is your expectation for how long it should have taken the NHSC to resolve your issue/situation?
No more than 24 hours
No more than 48 hours
No more than 3-4 days
No more than 1 week
No more than 1 month
(If Q5_7=No) If the NHSC representative was not able to resolve your issue, did they refer you elsewhere for further assistance?
Yes
No
(If Q5_10=Yes) Where did the NHSC representative refer you to? (Capture open-ended response)
Customer Service Portal
NHSC Website
Another department/representative
Other, please specify
Thinking about your most recent contact with the NHSC, and using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate…
Ease of reaching a NHSC representative
Courteousness of the NHSC representative
Knowledge of the NHSC representative
Timeliness of the representative’s response to your inquiry or concern
Relevance of the information provided by the NHSC representative
Level of service provided by the NHSC representative
Q5_19. Please use this space for any additional information you would like to provide the NHSC regarding ways we can improve the program. (Capture open-ended response)
Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate your overall experience at the site where you have fulfilled/are fulfilling your service obligation with the NHSC.
Please explain the reason for the rating you provided for your overall experience at the site where you have fulfilled/are fulfilling your service obligation with the NHSC. (Capture open-ended response)
Using a scale from 1 to 10, where 1 means “Not very prepared” and 10 means “Very Prepared”, please rate how prepared you felt for dealing with the patient population at your site while you fulfilled/are fulfilling your service obligation with the NHSC.
Please consider all of the experiences you have had with the NHSC program. Using a 10-point scale on which 1 means Very Dissatisfied and 10 means Very Satisfied, how satisfied are you with the NHSC program?
Using a 10-point scale on which 1 means Falls Short of Your Expectations and 10 means Exceeds Your Expectations, to what extent has the NHSC program fallen short of or exceeded your expectations?
Imagine an ideal scholarship and loan repayment program. How well do you think the NHSC compares with that ideal program? Please use a 10-point scale on which 1 means Not Very Close to Ideal, and 10 means Very Close to Ideal.
[ASK ONLY OF GROUP 1] On a scale from 1 to 10 where 1 means Not at All Likely and 10 means Very Likely, how likely are you to remain at your National Health Service Corps site after your service obligation is complete?
[ASK ONLY OF GROUP 1] On a scale from 1 to 10 where 1 means Not at All Likely and 10 means Very Likely, how likely are you to continue to provide health services in health professional shortage areas after your service obligation is completed
(If Q10>=7) What has contributed to the likelihood that you will continue to serve in a health professional shortage area (i.e., underserved community) after your service obligation is complete? (Select all that apply)
Salary
Opportunities for advancement
Cost of living
Experience at site
Site operation/direction closely aligned with my personal goals
Balanced schedule/hours
Use of electronic health record system
Use of telemedicine
Availability of distance learning opportunities
Availability of resources to do my job well
Community support
Close to extended family/parents and siblings
Family wanted to stay in community
Spouse employment opportunities
School district
Other, please specify
(If Q10<7) What would increase your likelihood to continue to serve in a health professional shortage area (i.e., underserved community) after your service obligation is complete?
Salary
Opportunities for advancement
Cost of living
Experience at site
Site operation/direction closely aligned with my personal goals
Balanced schedule/hours
Use of electronic health record system
Use of telemedicine
Availability of distance learning opportunities
Availability of resources to do my job well
Community support
Close to extended family/parents and siblings
Family wanted to stay in community
Spouse employment opportunities
School district
Other, please specify
On a scale from 1 to 10 where 1 means Not at Al l Likely and 10 means Very Likely, how likely are you to recommend the National Health Service Corps to someone else?
DEM1. What is your gender? (Select one)
Male
Female
Transgender Male
Transgender Female
Prefer not to say
DEM2. What is your age? (Select one)
18-24
25-34
35-44
45-54
55-64
65 and over
DEM3. What is your ethnicity?
Hispanic or Latino
Not Hispanic or Latino
Prefer not to say
DEM4. What is your race? (Select all that apply)
1. American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other, please specify
Prefer not to say
DEM5. Do you speak a language other than English?
Yes
No
DEM6. (If DEM5=1) What language(s), other than English, do you speak? (Select all that apply)
Spanish
French
German
Chinese/Mandarin
Hindi
Arabic
Portuguese
Vietnamese
Russian
Other, please specify
DEM7 Are you able to use this other language at your job?
Yes
No
DEM8. (Groups 1 and 2 only) Are you currently practicing, or have you practiced, in an underserved area that is within 100 miles of where you grew up? (Select one)
Yes
No
DEM9. (Groups 1 and 2) Are you currently practicing, or have you practiced, in an underserved area that is within 100 miles of where you completed your clinical training? (Select one)
Yes
No
DEM10. (Group 3) Are you currently attending health professions school within 100 miles of where you grew up/where you consider home?
Yes
No
DEM11. (Group 3) Do you plan to practice within 100 miles of where you completed your health professions training?
Yes
No
DEM12. (Group 3 and DEM10=NO) Do you plan to practice within 100 miles of where you grew up/where you consider home?
Yes
No
DEM13. (Group 1) From the list below, please select the option that best describes where you currently practice:
Federally Qualified Health Center (FQHC)
FQHC Look-Alike
Rural Health Clinic
Hospital Affiliated Primary Care Out-Patient Clinic
Indian Health Service
Tribal Clinic
Urban Indian Health Clinic
Correctional Facility
Private Practice (Solo/Group)
Community Mental Health Facility
Community Outpatient Facility
Critical Access Hospital
Free Clinic
Immigration and Customs Enforcement (ICE) Health Service Corps
Mobile Unit
School-based Health Program
State and County Department of Health Clinic
DEM 14. (Group 2 only) From the list below, please select the NHSC site that best describes where you were working when you finished your service obligation.
Federally Qualified Health Center (FQHC)
FQHC Look-Alike
Rural Health Clinic
Hospital Affiliated Primary Care Out-Patient Clinic
Indian Health Service
Tribal Clinic
Urban Indian Health Clinic
Correctional Facility
Private Practice (Solo/Group)
Community Mental Health Facility
Community Outpatient Facility
Critical Access Hospital
Free Clinic
Immigration and Customs Enforcement (ICE) Health Service Corps
Mobile Unit
School-based Health Program
State and County Department of Health Clinic
DEM 15. (Group 2 only) Where are you practicing now? Please select from the list below.
No longer providing direct patient care (Skip to end)
Private Practice (Solo/Group)
Federally Qualified Health Center (FQHC)
FQHC Look-Alike
Rural Health Clinic
Hospital Affiliated Primary Care Out-Patient Clinic
Indian Health Service
Tribal Clinic
Urban Indian Health Clinic
Correctional Facility
Community Mental Health Facility
Community Outpatient Facility
Critical Access Hospital
Free Clinic
Immigration and Customs Enforcement (ICE) Health Service Corps
Mobile Unit
School-based Health Program
State and County Department of Health Clinic
Other, please specify
DEM 16. (Groups 1 and 2) How large is your organization (total patients seen per year)?
1-2,500 patients
2,501-5,000 patients
5,001-7,500 patients
7,501-10,000 patients
Over 10,000 patients
DEM17. (Groups 1 and 2) Please list the zip-code of the site where you are currently practicing. (Capture numerical response)
DEM18. (Groups 1 and 2) From the drop-down box below, please select the state where you are currently practicing?
DEM19. (Group 3) From the drop-down box below, please select the state where you are currently attending health professions school?
Thank you for your time. The Health Resources and Services Administration’s National Health Service Corps appreciates your input!
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | HRSA OPR |
Author | Heather Reed/Sheri Teodoru |
File Modified | 0000-00-00 |
File Created | 2021-01-25 |