Generic Veterans Health Administration Customer Satisfaction Surveys

Generic Veterans Health Administration Customer Satisfaction Survey - Care Coordination Home Telehealth (CCHT)

CCHT Electronic Survey Questions

Generic Veterans Health Administration Customer Satisfaction Surveys

OMB: 2900-0570

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ELECTRONIC SURVEY QUESTIONS


Office of Care Coordination Services

CCHT Patient Satisfaction




  1. My care coordinator explains things in a way that is easy to understand.

  • Always

  • Usually

  • Sometimes

  • Never


  1. The information provided by my care coordinator has helped me manage my health problem(s).

  • Strongly Agree

  • Agree

  • Disagree

  • Strongly Disagree


  1. Over the past 3 months, my home telehealth equipment works:

  • Always

  • Usually

  • Sometimes

  • Never


  1. My home telehealth equipment is easy to use.

  • Strongly Agree

  • Agree

  • Disagree

  • Strongly Disagree


5. I have made changes in the way I take care of myself as a result of the VA home telehealth program.

  • Strongly Agree

  • Agree

  • Disagree

  • Strongly Disagree


6. When I have questions, I am able to contact my care coordinator during business hours.

  • Always

  • Usually

  • Sometimes

  • Never


7. Using the VA home telehealth program has made a positive difference in my health.

  • Strongly Agree

  • Agree

  • Disagree

  • Strongly Disagree


8. I would recommend a home telehealth program to others.

  • Strongly Agree

  • Agree

  • Disagree

  • Strongly Disagree



File Typeapplication/msword
File TitleDepartment of Memorandum
AuthorVHA User
File Modified2009-01-21
File Created2009-01-21

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