Screnn Shots

Behavioral Health Information Technologies and Standards

Task 7.2 Quantitative Data Collection

Attachment X: Survey Questionnaire Screenshots

Survey Introduction

Section 1: Grantee Program Information and Characteristics (Page 1)

Section 1: Grantee Program Information and Characteristics (Page 2 - Top)

Section 1: Grantee Program Information and Characteristics (Page 2 - Continued)

Section 1: Grantee Program Information and Characteristics (Page 2 - Bottom)

Section 2: Grantee Program Information Technology Resources (Page 3)

Section 2: Grantee Program Information Technology Resources (Page 4 - Top)

Section 2: Grantee Program Information Technology Resources (Page 4 - Continued)

Section 2: Grantee Program Information Technology Resources (Page 4 - Bottom)

Section 2: Grantee Program Information Technology Resources (Page 5 - Top)

Section 2: Grantee Program Information Technology Resources (Page 5 - Bottom)

Section 3: Certified Electronic Health Record Technology (Page 6)

Section 3: Certified Electronic Health Record Technology (Page 7)

Section 3: Certified Electronic Health Record Technology (Page 8 - Top)

Section 3: Certified Electronic Health Record Technology (Page 8 - Continued)

Section 3: Certified Electronic Health Record Technology (Page 8 - Bottom)

Section 3: Certified Electronic Health Record Technology (Page 9 - Top)

Section 3: Certified Electronic Health Record Technology (Page 9 - Bottom)

Section 3: Certified Electronic Health Record Technology (Page 10 - Top)

Section 3: Certified Electronic Health Record Technology (Page 10 - bottom)

Section 4: Use of Telehealth (includes Telemedicine) (Page 11)

Section 4: Use of Telehealth (includes Telemedicine) (Page 12 - Top)

Section 4: Use of Telehealth (includes Telemedicine) (Page 12 - Bottom)

Section 4: Use of Telehealth (includes Telemedicine) (Page 13 - Top)

Section 4: Use of Telehealth (includes Telemedicine) (Page 13 - Bottom)

Section 4: Use of Telehealth (includes Telemedicine) (Page 14)

Section 5: Mobile Technology (mHealth) (Page 15)

Section 5: Mobile Technology (mHealth) (Page 16 - Top)

Section 5: Mobile Technology (mHealth) (Page 16 - Continued)

Section 5: Mobile Technology (mHealth) (Page 16 - Bottom)

Section 5: Mobile Technology (mHealth) (Page 17 - Top)

Section 5: Mobile Technology (mHealth) (Page 17 - Bottom)

Section 6: Social Media (Page 18)

Section 6: Social Media (Page 19 - Top)

Section 6: Social Media (Page 19 - Bottom)

Section 6: Social Media (Page 20)

Thank You (Page 21)