Form 30715 2021 Proposed-Revision_VHA_Medical_Centers_Questio
E-Government Website Customer Satisfaction Surveys
30715 2021 Proposed-Revision_VHA_Medical_Centers_Questionnaire Nov_3_2021.xlsx
30715 2021 Proposed-Revision_VHA_Medical_Centers_Questionnaire Nov_3_2021
OMB: 1090-0008
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1090-0008 can be found here:
Document [xlsx]
Download: xlsx | pdf
Current Custom Qsts
Custom Qsts (5-5-20)
Custom Qsts (3-8-18)
Types
Custom Qsts (7-2-15)
Custom Qsts (12-13-10)
Custom Qsts (1-19-15)
Custom Qsts (4-10-13)
Custom Qsts (8-16-10)
Sheet3
Overview
Current Model QstsCurrent Custom Qsts
Custom Qsts (5-5-20)
Custom Qsts (3-8-18)
Types
Custom Qsts (7-2-15)
Custom Qsts (12-13-10)
Custom Qsts (1-19-15)
Custom Qsts (4-10-13)
Custom Qsts (8-16-10)
Sheet3
Sheet 1: Current Model Qsts
| Model Name | VHA Medical Centers V2 | |||||||
| Model ID | Underlined & Italicized: Re-order | |||||||
| Partitioned | 2MQ | Pink: Addition | ||||||
| Date | 12/14/2017 | Blue: Reword | ||||||
| Label | Element Questions | Label | Satisfaction Questions | Label | Future Behaviors | |||
| Look and Feel (1=Poor, 10=Excellent, Don't Know) | Satisfaction | Return (1=Very Unlikely, 10=Very Likely) | ||||||
| 1 | Look and Feel - Appeal | Please rate the visual appeal of this site. | 19 | Satisfaction - Overall | What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied) |
22 | Return | How likely are you to return to NOAA NGS? |
| 2 | Look and Feel - Balance | Please rate the balance of graphics and text on this site. | 20 | Satisfaction - Expectations | How well does this site meet your expectations? (1=Falls Short, 10=Exceeds) |
Recommend (1=Very Unlikely, 10=Very Likely) | ||
| 3 | Look and Feel - Readability | Please rate the readability of the pages on this site. | 21 | Satisfaction - Ideal | How does this site compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close) |
23 | Recommend | How likely are you to recommend NOAA NGS to someone else? |
| Site Performance (1=Poor, 10=Excellent, Don't Know) | ||||||||
| 4 | Site Performance - Loading | Please rate how quickly pages load on this site. | ||||||
| 5 | Site Performance - Consistency | Please rate the consistency of speed from page to page on this site. | ||||||
| 6 | Site Performance - Completeness | Please rate how completely the page content loads on this site. | ||||||
| Navigation (1=Poor, 10=Excellent, Don't Know) | ||||||||
| 7 | Navigation - Organized | Please rate how well the site is organized. | ||||||
| 8 | Navigation - Options | Please rate the options available for navigating this site. | ||||||
| 9 | Navigation - Layout | Please rate how well the site layout helps you find what you are looking for. | ||||||
| Information Browsing (1=Poor, 10=Excellent, Don't Know) | ||||||||
| 10 | Information Browsing - Sort | Please rate the ability to sort information by criteria that are important to you on this site. | ||||||
| 11 | Information Browsing - Narrow | Please rate the ability to narrow choices to find the information you are looking for on this site. | ||||||
| 12 | Information Browsing - Features | Please rate how well the features on the site help you find the information you need. | ||||||
| Site Information (1=Poor, 10=Excellent, Don't Know) | ||||||||
| 13 | Site Information - Thoroughness | Please rate the thoroughness of information provided on this site. | ||||||
| 14 | Site Information - Understandable | Please rate how understandable this site’s information is. | ||||||
| 15 | Site Information - Answers | Please rate how well the site’s information provides answers to your questions. |
Sheet 2: Current Custom Qsts
| 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 | Skip Logic | Visit Frequency | |||
| A few times a year | ||||||||||
| About once a month | ||||||||||
| About once a week | ||||||||||
| More than once a week | ||||||||||
| EDO03867 | What is your primary role in visiting this VA website today? | Veteran | B | Radio button, one-up vertical | Single | Y | Skip Logic | Role | ||
| Active Duty | B | |||||||||
| Family Member / Friend | ||||||||||
| VA Employee | ||||||||||
| Volunteer | ||||||||||
| Healthcare Professional (MD, RN, etc.) | ||||||||||
| Job Applicant | ||||||||||
| Student / Healthcare Trainee | ||||||||||
| Media | ||||||||||
| Other | A | |||||||||
| EDO03868 | A | Please specify your other role. | Text area, no char limit | Single | N | Skip Logic | OE_Role | |||
| EDO03869 | B | Please check the conflict(s) in which you served. | World War II | Checkbox, one-up vertical | Multi | Y | Skip Logic | Conflict | ||
| Korean Conflict | ||||||||||
| Vietnam Era | ||||||||||
| Gulf War | ||||||||||
| Operation Enduring Freedom | ||||||||||
| Operation Iraqi Freedom | ||||||||||
| Operation New Dawn | ||||||||||
| 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 | ||||||||||
| 65-74 | ||||||||||
| 75+ | ||||||||||
| Prefer not to answer | ||||||||||
(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). |
||||||||||
| EDO03925 | What type of information were you trying to find on this medical center website? (Check all that apply) | Facility information | B | Checkbox, one-up vertical | Multi | Y | Skip Logic | Type of Information Seeking | ||
| Specific health issue information | C | |||||||||
| Benefits information | D | |||||||||
| Make, change, or cancel an appointment | ||||||||||
| Prescription refills | ||||||||||
| Jobs or volunteering info | ||||||||||
| Health Education Activities (classes, tutorials, etc.) | H | |||||||||
| Healthcare Professional Training (Students, Residents, etc.) | ||||||||||
| Other | A | |||||||||
| EDO03926 | A | Please specify the information you were trying to find. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Reason | |||
| RUS0166251 | B | What facility information you were looking for? (Check all that apply) | Facility contact information | Checkbox, one-up vertical | Multi | Y | Skip Logic | Facility Information | ||
| Contact information for a doctor or clinic | ||||||||||
| Directions / Locations | ||||||||||
| Hours of Operation | ||||||||||
| Services Available | ||||||||||
| Other | E | |||||||||
| RUS0166252 | E | Please specify what other facility information you were looking for. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Facility | |||
| RUS0216244 | C | What health information were you looking for? (Check all that apply) | PTSD | Checkbox, one-up vertical | Multi | Y | Skip Logic | Health Condition | ||
| Other mental-health conditions | ||||||||||
| Exposures (Agent Orange, airborne hazards, etc.) | ||||||||||
| Traumatic Brain Injury | ||||||||||
| Military Sexual Trauma | ||||||||||
| COVID-19-related health information | ||||||||||
| Preventative medicine | ||||||||||
| Health and well being | ||||||||||
| Rehabilitation | ||||||||||
| Labs and Tests | ||||||||||
| Medications | ||||||||||
| Other | F | Mutually Exclusive | ||||||||
| RUS0216245 | F | Please specify the health information you were looking for. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Condition | |||
| RUS0166254 | D | What benefits-related information were you seeking? (Check all that apply) | Disability compensation | Checkbox, one-up vertical | Multi | Y | Skip Logic | Benefits | ||
| Education and training | ||||||||||
| Employment services | ||||||||||
| Health care | ||||||||||
| Home loans and housing-related assistance | ||||||||||
| Life insurance | ||||||||||
| Memorial benefits | ||||||||||
| Pension | ||||||||||
| Spouses, dependents and survivors | ||||||||||
| Other | G | |||||||||
| RUS0166255 | G | Please specify the benefits-related information you were seeking. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Benefits | |||
| H | Please specify the health education activities you were looking for. | Open-ended text, no char limit | N | Skip Logic | OE_Health Education | |||||
| EDO03927 | Did you find what you were looking today? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic | Find Info | |||
| Partially | B | |||||||||
| No, I was looking for: | A | |||||||||
| RUS0166256 | B | What information could have been improved to help answer your questions? | Open-ended text, no char limit | Single | N | Skip Logic | OE_Partial Find | |||
| EDO03928 | A | What specific information were you looking for? | Open-ended text, no char limit | Single | N | Skip Logic | OE_Find | |||
| Please rate your level of agreement with the following statement. The information I found on this website was easy to understand | 1=Strongly Disagree | AA | Radio button, scale, no don't know | Single | Y | Skip Logic | Info Understand | |||
| 2 | AA | |||||||||
| 3 | AA | |||||||||
| 4 | ||||||||||
| 5=Strongly Agree | ||||||||||
| AA | What could make the content easier to understand? | Open-ended text, no char limit | N | Skip Logic | OE_Info Understand | |||||
| Rate the amount of information you found: | Too much | Radio button | Single | Y | Skip Logic | Info Amount | ||||
| Too little | ||||||||||
| Just right | ||||||||||
| EDO03935 | Where did you first hear about this VA website? | During Enrollment | Radio button, one-up vertical | Single | Y | Skip Logic | How Hear | |||
| At the Medical Center | ||||||||||
| From my provider (doctor, nurse, social worker, etc.) | ||||||||||
| Search Engine (Google, Yahoo, etc.) | ||||||||||
| Social Networks (Facebook, Twitter, etc.) | ||||||||||
| www.va.gov | ||||||||||
| www.va.gov/health | ||||||||||
| I browsed directly to the site | ||||||||||
| Veteran Service Organization | ||||||||||
| Friend or family member | ||||||||||
| Other | A | |||||||||
| EDO03936 | A | Please specify how you first heard about this site. | Skip Logic | OE_How Hear | ||||||
Sheet 3: Custom Qsts (5-5-20)
| 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 | Skip Logic | Visit Frequency | |||
| A few times a year | ||||||||||
| About once a month | ||||||||||
| About once a week | ||||||||||
| More than once a week | ||||||||||
| EDO03867 | What is your primary role in visiting this VA website today? | Veteran | B | Radio button, one-up vertical | Single | Y | Skip Logic | Role | ||
| Active Duty | B | |||||||||
| Family Member / Friend | ||||||||||
| VA Employee | ||||||||||
| Volunteer | ||||||||||
| Healthcare Professional (MD, RN, etc.) | ||||||||||
| Job Applicant | ||||||||||
| Student / Healthcare Trainee | ||||||||||
| Media | ||||||||||
| Other | A | |||||||||
| EDO03868 | A | Please specify your other role. | Text area, no char limit | Single | N | Skip Logic | OE_Role | |||
| EDO03869 | B | Please check the conflict(s) in which you served. | World War II | Checkbox, one-up vertical | Multi | Y | Skip Logic | Conflict | ||
| Korean Conflict | ||||||||||
| Vietnam Era | ||||||||||
| Gulf War | ||||||||||
| Operation Enduring Freedom | ||||||||||
| Operation Iraqi Freedom | ||||||||||
| Operation New Dawn | ||||||||||
| 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 | ||||||||||
| 65-74 | ||||||||||
| 75+ | ||||||||||
| 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 | Skip Logic | 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 | S | Y | Skip Logic | Alaska | ||
| EDO03874 | B | Which Medical Center in Alabama do you visit? | Birmingham - Birmingham VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Alabama | ||
| 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 | S | Y | Skip Logic | Arkansas | ||
| 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 | S | Y | Skip Logic | Arizona | ||
| 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 | S | Y | Skip Logic | California | ||
| 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 | S | Y | Skip Logic | Colorado | ||
| 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 | S | Y | Skip Logic | Connecticut | ||
| 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 | S | Y | Skip Logic | DC | ||
| EDO03881 | I | Which Medical Center in Delaware do you visit? | Wilmington - Wilmington VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Delaware | ||
| EDO03882 | J | Which Medical Center in Florida do you visit? | Bay Pines - Bay Pines VA Healthcare System | Radio button, one-up vertical | S | Y | Skip Logic | Florida | ||
| 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 | S | Y | Skip Logic | Georgia | ||
| 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 | S | Y | Skip Logic | Hawaii | ||
| EDO03885 | M | Which Medical Center in Iowa do you visit? | Des Moines - VA Central Iowa Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Iowa | ||
| 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 | S | Y | Skip Logic | Idaho | ||
| EDO03887 | O | Which Medical Center in Illinois do you visit? | Chicago - Jesse Brown VA Medical Center | Radio button, one-up vertical | Illinois | |||||
| Danville - VA Illiana Health Care System | ||||||||||
| Hines - Edward Hines Jr. VA Hospital | ||||||||||
| Marion - Marion VA Medical Center | ||||||||||
| North Chicago – Captain James A. Lovell Federal Healthcare Center | ||||||||||
| EDO03888 | P | Which Medical Center in Indiana do you visit? | Fort Wayne - VA Northern Indiana Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Indiana | ||
| 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 | S | Y | Skip Logic | Kansas | ||
| 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 | S | Y | Skip Logic | Kentucky | ||
| Lexington - Lexington VA Medical Center (Leestown Division) | ||||||||||
| Louisville - Louisville VA Medical Center | ||||||||||
| EDO03891 | S | Which Medical Center in Louisiana do you visit? | New Orleans - Southeast Louisiana Veterans Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Louisiana | ||
| 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 | S | Y | Skip Logic | Massachusetts | ||
| Brockton - VA Boston Healthcare System | ||||||||||
| Jamaica Plain - VA Boston Healthcare System | ||||||||||
| Leeds – Central Western Massachusetts Health Care System | ||||||||||
| 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 | S | Y | Skip Logic | Maryland | ||
| 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 | S | Y | Skip Logic | Maine | ||
| EDO03895 | W | Which Medical Center in Michigan do you visit? | Ann Arbor - VA Ann Arbor Healthcare System | Radio button, one-up vertical | S | Y | Skip Logic | Michigan | ||
| 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 | S | Y | Skip Logic | Minnesota | ||
| 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 | S | Y | Skip Logic | Missouri | ||
| 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 | S | Y | Skip Logic | Mississippi | ||
| 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 | S | Y | Skip Logic | Montana | ||
| EDO03900 | BB | Which Medical Center in North Carolina do you visit? | Asheville - Asheville VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | North Carolina | ||
| 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 | S | Y | Skip Logic | North Dakota | ||
| EDO03902 | DD | Which Medical Center in Nebraska do you visit? | Omaha - VA Nebraska-Western Iowa Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Nebraska | ||
| EDO03903 | EE | Which Medical Center in New Hampshire do you visit? | Manchester - Manchester VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | New Hampshire | ||
| EDO03904 | FF | Which Medical Center in New Jersey do you visit? | East Orange - VA New Jersey Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | New Jersey | ||
| 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 | S | Y | Skip Logic | New Mexico | ||
| EDO03906 | HH | Which Medical Center in Nevada do you visit? | Las Vegas - VA Southern Nevada Healthcare System | Radio button, one-up vertical | Nevada | |||||
| 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 | S | Y | Skip Logic | New York | ||
| Batavia - VA Western New York Healthcare System | ||||||||||
| Bronx - James J. Peters VA Medical Center | ||||||||||
| Brooklyn - VA NY Harbor Healthcare System | ||||||||||
| Buffalo - VA Western New York Healthcare System | ||||||||||
| Castle Point - VA Hudson Valley Health Care System | ||||||||||
| Finger Lakes - VA Finger Lakes Healthcare 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 | S | Y | Skip Logic | Ohio | ||
| 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 | S | Y | Skip Logic | Oklahoma | ||
| 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 | S | Y | Skip Logic | Oregon | ||
| Portland - Portland VA Medical Center | ||||||||||
| EDO03911 | MM | Which Medical Center in Pennsylvania do you visit? | Altoona - James E. Van Zandt VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Pennsylvania | ||
| 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) | ||||||||||
| Pittsburgh - VA Pittsburgh Healthcare System (H.J. Heinz Progressive Care Center) | ||||||||||
| 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 | S | Y | Skip Logic | Puerto Rico | ||
| EDO03913 | OO | Which Medical Center in Rhode Island do you visit? | Providence - Providence VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Rhode Island | ||
| EDO03914 | PP | Which Medical Center in South Carolina do you visit? | Charleston - Ralph H. Johnson VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | South Carolina | ||
| 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 | S | Y | Skip Logic | South Dakota | |||
| 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 | S | Y | Skip Logic | Tennessee | ||
| 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 | S | Y | Skip Logic | Texas | ||
| 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 | S | Y | Skip Logic | Utah | ||
| EDO03919 | UU | Which Medical Center in Virginia do you visit? | Hampton - Hampton VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Virginia | ||
| 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 | S | Y | Skip Logic | Vermont | ||
| EDO03921 | WW | Which Medical Center in Washington do you visit? | Seattle - VA Puget Sound Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Washington | ||
| 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 | S | Y | Skip Logic | Wisconsin | ||
| 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 | S | Y | Skip Logic | West Virginia | ||
| 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 | S | Y | Skip Logic | Wyoming | ||
| Sheridan - Sheridan VA Medical Center | ||||||||||
| EDO03925 | What type of information were you trying to find on this medical center website? (Check all that apply) | Facility information | B | Checkbox, one-up vertical | Multi | Y | Skip Logic | Type of Information Seeking | ||
| Specific health issue information | C | |||||||||
| Benefits information | D | |||||||||
| Make, change, or cancel an appointment | ||||||||||
| Prescription refills | ||||||||||
| Jobs or volunteering info | ||||||||||
| Health Education (classes, tutorials, etc.) | ||||||||||
| Healthcare Professional Training (Students, Residents, etc.) | ||||||||||
| Other | A | |||||||||
| EDO03926 | A | Please specify the information you were trying to find. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Reason | |||
| RUS0166251 | B | What facility information you were looking for? (Check all that apply) | Facility contact information | Checkbox, one-up vertical | Multi | Y | Skip Logic | Facility Information | ||
| Contact information for a doctor or clinic | ||||||||||
| Directions / Locations | ||||||||||
| Hours of Operation | ||||||||||
| Services Available | ||||||||||
| Other | E | |||||||||
| RUS0166252 | E | Please specify what other facility information you were looking for. | E | Open-ended text, no char limit | Single | N | Skip Logic | OE_Facility | ||
| RUS0216244 | C | What health condition were you seeking information on? (Check all that apply) | Mental-health conditions | Checkbox, one-up vertical | Multi | Y | Skip Logic | Health Condition | ||
| PTSD | ||||||||||
| Agent Orange exposure | ||||||||||
| I'd prefer not to say | Mutually Exclusive | |||||||||
| Other | F | |||||||||
| RUS0216245 | F | Please specify the health condition you were seeking information on. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Condition | |||
| RUS0166254 | D | What benefits-related information were you seeking? (Check all that apply) | Disability compensation | Checkbox, one-up vertical | Multi | Y | Skip Logic | Benefits | ||
| Education and training | ||||||||||
| Employment services | ||||||||||
| Health care | ||||||||||
| Home loans and housing-related assistance | ||||||||||
| Life insurance | ||||||||||
| Memorial benefits | ||||||||||
| Pension | ||||||||||
| Spouses, dependents and survivors | ||||||||||
| Other | G | |||||||||
| RUS0166255 | G | Please specify the benefits-related information you were seeking. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Benefits | |||
| EDO03927 | Did you find what you were looking today? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic | Find Info | |||
| Partially | B | |||||||||
| No, I was looking for: | A | |||||||||
| RUS0166256 | B | What information could have been improved to help answer your questions? | Open-ended text, no char limit | Single | N | Skip Logic | OE_Partial Find | |||
| EDO03928 | A | What specific information were you unable to find? | Open-ended text, no char limit | Single | N | Skip Logic | OE_Find | |||
| 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 | Skip Logic | Services Adequate | |||
| No | A | |||||||||
| EDO03934 | A | Why not? | Text area, no char limit | Skip Logic | OE_Not Adequate | |||||
| EDO03935 | Where did you first hear about this VA website? | During Enrollment | Radio button, one-up vertical | Single | Y | Skip Logic | How Hear | |||
| At the Medical Center | ||||||||||
| From my provider (doctor, nurse, social worker, etc.) | ||||||||||
| Search Engine (Google, Yahoo, etc.) | ||||||||||
| Social Networks (Facebook, Twitter, etc.) | ||||||||||
| www.va.gov | ||||||||||
| www.va.gov/health | ||||||||||
| I browsed directly to the site | ||||||||||
| Veteran Service Organization | ||||||||||
| Friend or family member | ||||||||||
| Other | A | |||||||||
| EDO03936 | A | Please specify how you first heard about this site. | Skip Logic | 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 | Skip Logic | Add Info | ||
| No | ||||||||||
| EDO03938 | A | How would you like to see this information? (Check all that apply) | Directly on the medical center's website | Checkbox, one-up vertical | Multi | Y | Skip Logic | How Add Info | ||
| YouTube | ||||||||||
| Flickr | ||||||||||
| Google+ | ||||||||||
| RSS | ||||||||||
| SMS / Text Messaging | ||||||||||
| EDO03931 | Do you use MyHealtheVet (prescription refills, personal health record, etc.)? | Yes | A | Radio button, one-up vertical | Single | Y | Skip Logic | MHV Usage | ||
| No | B | |||||||||
| EDO03939 | A | Have you completed the In-Person Authentication (IPA) which allows you to view the names of your prescriptions, view lab test results, and see your upcoming appointments? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic | IPA | ||
| No | ||||||||||
| EDO03932 | B | Why not? | Text area, no char limit | Single | N | Skip Logic | OE_Not Use MHV | |||
| EDO03929 | Do you use any of the following while on the Internet? (Check all that apply) | B | Checkbox, one-up vertical | Multi | Y | Skip Logic | Social media | |||
| C | ||||||||||
| YouTube | ||||||||||
| Google+ | ||||||||||
| Foursquare | ||||||||||
| Yelp | ||||||||||
| Flickr | ||||||||||
| Blogs | ||||||||||
| Podcasts | ||||||||||
| I do not use any of these social media tools. | 8889 | |||||||||
| Other | A | |||||||||
| EDO03930 | A | Please specify other social media sites you use. | Text area, no char limit | Single | N | Skip Logic | OE_Social Media | |||
| RUS0166271 | B | Do you interact with the VA on Facebook? | Yes | Radio button, one-up vertical | Single | N | Skip Logic | |||
| No | ||||||||||
| RUS0166272 | C | Do you interact with the VA on Twitter? | Yes | Radio button, one-up vertical | Single | N | Skip Logic | |||
| No | ||||||||||
| HAR0074484 | Do you ever access the Internet using a mobile phone or tablet? | Yes | A, B, D | Radio button, one-up vertical | Single | Y | Skip Logic | Access Mobile Internet | ||
| No | ||||||||||
| HAR0074485 | A | Which of the following devices do you have? | A SmartPhone | W | Checkbox, one-up vertical | Multi | Y | Skip Logic | Phone or Tablet | |
| A tablet | X | |||||||||
| None of these | Mutually Exclusive | |||||||||
| HAR0074486 | W | Specifically, which type of smartphone do you have? | iPhone | Radio button, one-up vertical | Single | Y | Skip Logic | Phone Type | ||
| Android | ||||||||||
| Another phone | ||||||||||
| HAR0074487 | X | Specifically, which type of tablet do you have? | iPad | Radio button, one-up vertical | Single | Y | Skip Logic | Tablet Type | ||
| Kindle | ||||||||||
| Android | ||||||||||
| Another tablet | ||||||||||
| HAR0074488 | B | Have you ever accessed ANY federal website using a smartphone or tablet? | Yes | C | Radio button, one-up vertical | Single | Y | Skip Logic | Federal Mobile Site Usage | |
| No, but I plan to do so | ||||||||||
| No, but I might in the future | ||||||||||
| No, and I don't plan to do so | ||||||||||
| HAR0074489 | C | Have you ever accessed a VA medical center site using a smartphone or tablet? | Yes | Y, Z | Radio button, one-up vertical | Single | Y | Skip Logic | Mobile Site Usage | |
| No, but I plan to do so | Z | |||||||||
| No, but I might in the future | Z | |||||||||
| No, and I don't plan to do so | ||||||||||
| HAR0074491 | Y | What was the main reason you last visited a VA medical center site using a smartphone or tablet? | Text area, no char limit | Single | N | Skip Logic | Primary Reason | |||
| HAR0074492 | Z | What resources/additional resources might you want to access from a VA medical center site using a smartphone or tablet? | Text area, no char limit | Single | N | Skip Logic | Desired Resources | |||
| HAR0074490 | D | Have you ever accessed a VA Medical Center Social Media site (e.g. Facebook, Twitter, etc.) using a smartphone or tablet? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic | Mobile Social Media | ||
| No, but I plan to do so | ||||||||||
| No, but I might in the future | ||||||||||
| No, and I don't plan to do so | ||||||||||
| RUS0216246 | Have you ever accessed a VA Medical Center website while actually visiting a medical center location? (i.e. on a mobile device) | A | Radio button, one-up vertical | Single | Y | Skip Logic | Access on Location | |||
| Yes | ||||||||||
| No | ||||||||||
| Not sure | ||||||||||
| RUS0216247 | A | Please explain the main reason you accessed the website while visiting the medical center. | Text area, no char limit | Single | N | Skip Logic | OE_Location | |||
| RUS0166273 | How did you look for information on or navigate the site today? (Check all that apply) | Top navigation bar | L | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | How Look for Info | ||
| Links in the center of the page | L | Randomize | ||||||||
| Site map | L | |||||||||
| Search feature | M | |||||||||
| Other | L, N | Anchor Answer Choice | ||||||||
| RUS0166274 | N | How did you look for information or navigate the site? | Text area, no char limit | Single | N | Skip Logic Group* | OPS_How Look for Info | |||
| RUS0166275 | L | How would you describe your experience navigating the site today? (Check all that apply) | Links often did not take me where I expected | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | Navigation Experience | ||
| Links/labels are difficult to understand | ||||||||||
| Too many links/navigational options to choose from | ||||||||||
| Had technical difficulties (error messages, broken links, etc.) | ||||||||||
| Could not navigate back to previous information | ||||||||||
| I had another navigation difficulty | O | |||||||||
| I had no difficulty navigating on this site | Mutually Exclusive | |||||||||
| RUS0166277 | O | Please tell us about the difficulty you experienced navigating the site. | Text area, no char limit | Single | N | Skip Logic Group* | OPS_Navigation Experience | |||
| RUS0166276 | M | Please tell us about your experience with the site's search feature today. (Check all that apply) | I had issues with the basic search process (how to use it, terms to enter). | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | Search Experience | ||
| I had issues with the visual display of the search results (text size, images). | ||||||||||
| I had issues with the search results I received. | Z | |||||||||
| I had issues with sorting, filtering, advanced search, or lack of these options. | ||||||||||
| I had technical issues with the search feature. | P | |||||||||
| I had another search difficulty. | Q | |||||||||
| The search feature met my needs today. | Mutually Exclusive | |||||||||
| RUS0166278 | Q | Please tell us about the difficulty you experienced with the search feature. | Text area, no char limit | Single | N | Skip Logic Group* | OPS_Search Experience | |||
| RUS0166280 | P | Please explain the technical issue you experienced with search. | Text area, no char limit | Single | N | Skip Logic Group* | OE_Technical Issue | |||
| RUS0166282 | Z | What were your issues with the search results? (Check all that apply) | Results were not relevant/not what I wanted | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | Search Results Issue | ||
| There were not enough results | ||||||||||
| There were NO results | ||||||||||
| There was too little information in the results to decide what to choose | ||||||||||
| Many of the search results looked the same | ||||||||||
| I had another issue with the search results. | R | |||||||||
| RUS0166284 | R | Please explain the issue(s) you experienced with your search results. | Text area, no char limit | Single | N | Skip Logic Group* | OPS_Search Results Issue | |||
Sheet 4: Custom Qsts (3-8-18)
| 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 | Skip Logic | Visit Frequency | |||
| A few times a year | ||||||||||
| About once a month | ||||||||||
| About once a week | ||||||||||
| More than once a week | ||||||||||
| EDO03867 | What is your primary role in visiting this VA website today? | Veteran | B | Radio button, one-up vertical | Single | Y | Skip Logic | Role | ||
| Active Duty | B | |||||||||
| Family Member / Friend | ||||||||||
| VA Employee | ||||||||||
| Volunteer | ||||||||||
| Healthcare Professional (MD, RN, etc.) | ||||||||||
| Job Applicant | ||||||||||
| Student / Healthcare Trainee | ||||||||||
| Media | ||||||||||
| Other | A | |||||||||
| EDO03868 | A | Please specify your other role. | Text area, no char limit | Single | N | Skip Logic | OE_Role | |||
| EDO03869 | B | Please check the conflict(s) in which you served. | World War II | Checkbox, one-up vertical | Multi | Y | Skip Logic | Conflict | ||
| Korean Conflict | ||||||||||
| Vietnam Era | ||||||||||
| Persian Gulf War | ||||||||||
| Operation Enduring Freedom | ||||||||||
| Operation Iraqi Freedom | ||||||||||
| Operation New Dawn | ||||||||||
| 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 | ||||||||||
| 65-74 | ||||||||||
| 75+ | ||||||||||
| 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 | Skip Logic | 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 | S | Y | Skip Logic | Alaska | ||
| EDO03874 | B | Which Medical Center in Alabama do you visit? | Birmingham - Birmingham VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Alabama | ||
| 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 | S | Y | Skip Logic | Arkansas | ||
| 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 | S | Y | Skip Logic | Arizona | ||
| 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 | S | Y | Skip Logic | California | ||
| 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 | S | Y | Skip Logic | Colorado | ||
| 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 | S | Y | Skip Logic | Connecticut | ||
| 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 | S | Y | Skip Logic | DC | ||
| EDO03881 | I | Which Medical Center in Delaware do you visit? | Wilmington - Wilmington VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Delaware | ||
| EDO03882 | J | Which Medical Center in Florida do you visit? | Bay Pines - Bay Pines VA Healthcare System | Radio button, one-up vertical | S | Y | Skip Logic | Florida | ||
| 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 | S | Y | Skip Logic | Georgia | ||
| 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 | S | Y | Skip Logic | Hawaii | ||
| EDO03885 | M | Which Medical Center in Iowa do you visit? | Des Moines - VA Central Iowa Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Iowa | ||
| 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 | S | Y | Skip Logic | Idaho | ||
| EDO03887 | O | Which Medical Center in Illinois do you visit? | Chicago - Jesse Brown VA Medical Center | Radio button, one-up vertical | Illinois | |||||
| Danville - VA Illiana Health Care System | ||||||||||
| Hines - Edward Hines Jr. VA Hospital | ||||||||||
| Marion - Marion VA Medical Center | ||||||||||
| North Chicago – Captain James A. Lovell Federal Healthcare Center | ||||||||||
| EDO03888 | P | Which Medical Center in Indiana do you visit? | Fort Wayne - VA Northern Indiana Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Indiana | ||
| 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 | S | Y | Skip Logic | Kansas | ||
| 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 | S | Y | Skip Logic | Kentucky | ||
| Lexington - Lexington VA Medical Center (Leestown Division) | ||||||||||
| Louisville - Louisville VA Medical Center | ||||||||||
| EDO03891 | S | Which Medical Center in Louisiana do you visit? | New Orleans - Southeast Louisiana Veterans Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Louisiana | ||
| 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 | S | Y | Skip Logic | Massachusetts | ||
| Brockton - VA Boston Healthcare System | ||||||||||
| Jamaica Plain - VA Boston Healthcare System | ||||||||||
| Leeds – Central Western Massachusetts Health Care System | ||||||||||
| 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 | S | Y | Skip Logic | Maryland | ||
| 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 | S | Y | Skip Logic | Maine | ||
| EDO03895 | W | Which Medical Center in Michigan do you visit? | Ann Arbor - VA Ann Arbor Healthcare System | Radio button, one-up vertical | S | Y | Skip Logic | Michigan | ||
| 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 | S | Y | Skip Logic | Minnesota | ||
| 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 | S | Y | Skip Logic | Missouri | ||
| 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 | S | Y | Skip Logic | Mississippi | ||
| 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 | S | Y | Skip Logic | Montana | ||
| EDO03900 | BB | Which Medical Center in North Carolina do you visit? | Asheville - Asheville VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | North Carolina | ||
| 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 | S | Y | Skip Logic | North Dakota | ||
| EDO03902 | DD | Which Medical Center in Nebraska do you visit? | Omaha - VA Nebraska-Western Iowa Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Nebraska | ||
| EDO03903 | EE | Which Medical Center in New Hampshire do you visit? | Manchester - Manchester VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | New Hampshire | ||
| EDO03904 | FF | Which Medical Center in New Jersey do you visit? | East Orange - VA New Jersey Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | New Jersey | ||
| 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 | S | Y | Skip Logic | New Mexico | ||
| EDO03906 | HH | Which Medical Center in Nevada do you visit? | Las Vegas - VA Southern Nevada Healthcare System | Radio button, one-up vertical | Nevada | |||||
| 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 | S | Y | Skip Logic | New York | ||
| 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 | S | Y | Skip Logic | Ohio | ||
| 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 | S | Y | Skip Logic | Oklahoma | ||
| 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 | S | Y | Skip Logic | Oregon | ||
| Portland - Portland VA Medical Center | ||||||||||
| EDO03911 | MM | Which Medical Center in Pennsylvania do you visit? | Altoona - James E. Van Zandt VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Pennsylvania | ||
| 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) | ||||||||||
| Pittsburgh - VA Pittsburgh Healthcare System (H.J. Heinz Progressive Care Center) | ||||||||||
| 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 | S | Y | Skip Logic | Puerto Rico | ||
| EDO03913 | OO | Which Medical Center in Rhode Island do you visit? | Providence - Providence VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Rhode Island | ||
| EDO03914 | PP | Which Medical Center in South Carolina do you visit? | Charleston - Ralph H. Johnson VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | South Carolina | ||
| 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 | S | Y | Skip Logic | South Dakota | |||
| 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 | S | Y | Skip Logic | Tennessee | ||
| 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 | S | Y | Skip Logic | Texas | ||
| 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 | S | Y | Skip Logic | Utah | ||
| EDO03919 | UU | Which Medical Center in Virginia do you visit? | Hampton - Hampton VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Virginia | ||
| 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 | S | Y | Skip Logic | Vermont | ||
| EDO03921 | WW | Which Medical Center in Washington do you visit? | Seattle - VA Puget Sound Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Washington | ||
| 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 | S | Y | Skip Logic | Wisconsin | ||
| 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 | S | Y | Skip Logic | West Virginia | ||
| 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 | S | Y | Skip Logic | Wyoming | ||
| Sheridan - Sheridan VA Medical Center | ||||||||||
| EDO03925 | What type of information were you trying to find on this medical center website? (Check all that apply) | Checkbox, one-up vertical | Multi | Y | Skip Logic | Type of Information Seeking | ||||
| Facility information | B | |||||||||
| Specific health issue information | C | |||||||||
| Benefits information | D | |||||||||
| Make, change, or cancel an appointment | ||||||||||
| Prescription refills | ||||||||||
| Jobs or volunteering info | ||||||||||
| Health Education (classes, tutorials, etc.) | ||||||||||
| Healthcare Professional Training (Students, Residents, etc.) | ||||||||||
| Other | A | |||||||||
| EDO03926 | A | Please specify the information you were trying to find. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Reason | |||
| B | What facility information you were looking for? (Check all that apply) | Facility contact information | Checkbox, one-up vertical | Multi | Y | Skip Logic | Facility Information | |||
| Contact information for a doctor or clinic | ||||||||||
| Directions / Locations | ||||||||||
| Hours of Operation | ||||||||||
| Services Available | ||||||||||
| Other | E | |||||||||
| E | Please specify what other facility information you were looking for. | E | Open-ended text, no char limit | Single | N | Skip Logic | OE_Facility | |||
| C | What health condition were you seeking information on? (Check all that apply) | Mental-health conditions | Checkbox, one-up vertical | Multi | Y | Skip Logic | Health Condition | |||
| PTSD | ||||||||||
| Agent Orange exposure | ||||||||||
| I'd prefer not to say | Mutually Exclusive | |||||||||
| Other | F | |||||||||
| F | Please specify the health condition you were seeking information on. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Condition | ||||
| D | What benefits-related information were you seeking? (Check all that apply) | Disability compensation | Checkbox, one-up vertical | Multi | Y | Skip Logic | Benefits | |||
| Education and training | ||||||||||
| Employment services | ||||||||||
| Health care | ||||||||||
| Home loans and housing-related assistance | ||||||||||
| Life insurance | ||||||||||
| Memorial benefits | ||||||||||
| Pension | ||||||||||
| Spouses, dependents and survivors | ||||||||||
| Other | G | |||||||||
| G | Please specify the benefits-related information you were seeking. | Open-ended text, no char limit | Single | N | Skip Logic | OE_Benefits | ||||
| EDO03+308:312927 | Did you find what you were looking today? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic | Find Info | |||
| Partially | B | |||||||||
| No, I was looking for: | A | |||||||||
| B | What information could have been improved to help answer your questions? | Open-ended text, no char limit | Single | N | Skip Logic | OE_Partial Find | ||||
| EDO03928 | A | What specific information were you unable to find? | Open-ended text, no char limit | Single | N | Skip Logic | OE_Find | |||
| 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 | Skip Logic | Services Adequate | |||
| No | A | |||||||||
| EDO03934 | A | Why not? | Text area, no char limit | Skip Logic | OE_Not Adequate | |||||
| EDO03935 | Where did you first hear about this VA Medical Center website? | During Enrollment | Radio button, one-up vertical | Single | Y | Skip Logic | How Hear | |||
| At the Medical Center | ||||||||||
| From my provider (doctor, nurse, social worker, etc.) | ||||||||||
| Search Engine (Google, Yahoo, etc.) | ||||||||||
| Separate out Facebook and Twitter | Social Networks (Facebook, Twitter, etc.) | |||||||||
| www.va.gov | ||||||||||
| www.va.gov/health | ||||||||||
| I browsed directly to the site | ||||||||||
| Veteran Service Organization | ||||||||||
| Friend or family member | ||||||||||
| Other | A | |||||||||
| EDO03936 | A | Please specify how you first heard about this site. | Skip Logic | 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 | Skip Logic | Add Info | ||
| No | ||||||||||
| EDO03938 | A | How would you like to see this information? (Check all that apply) | Directly on the medical center's website | Checkbox, one-up vertical | Multi | Y | Skip Logic | How Add Info | ||
| YouTube | ||||||||||
| Flickr | ||||||||||
| Google+ | ||||||||||
| RSS | ||||||||||
| SMS / Text Messaging | ||||||||||
| EDO03931 | Do you use MyHealtheVet (prescription refills, personal health record, etc.)? | Yes | A | Radio button, one-up vertical | Single | Y | Skip Logic | MHV Usage | ||
| No | B | |||||||||
| EDO03939 | A | Have you completed the In-Person Authentication (IPA) which allows you to view the names of your prescriptions, view lab test results, and see your upcoming appointments? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic | IPA | ||
| No | ||||||||||
| EDO03932 | B | Why not? | Text area, no char limit | Single | N | Skip Logic | OE_Not Use MHV | |||
| EDO03929 | Do you use any of the following while on the Internet? (Check all that apply) | B | Checkbox, one-up vertical | Multi | Y | Skip Logic | Social media | |||
| C | ||||||||||
| YouTube | ||||||||||
| Google+ | ||||||||||
| Foursquare | ||||||||||
| Yelp | ||||||||||
| Flickr | ||||||||||
| Blogs | ||||||||||
| Podcasts | ||||||||||
| I do not use any of these social media tools. | 8889 | |||||||||
| Other | A | |||||||||
| EDO03930 | A | Please specify other social media sites you use. | Text area, no char limit | Single | N | Skip Logic | OE_Social Media | |||
| B | Do you interact with the VA on Facebook? | Radio button, one-up vertical | Single | N | Skip Logic | |||||
| C | Do you interact with the VA on Twitter? | Radio button, one-up vertical | Single | N | Skip Logic | |||||
| HAR0074484 | Do you ever access the Internet using a mobile phone or tablet? | Yes | A, B, D | Radio button, one-up vertical | Single | Y | Skip Logic | Access Mobile Internet | ||
| No | ||||||||||
| HAR0074485 | A | Which of the following devices do you have? | A SmartPhone | W | Checkbox, one-up vertical | Multi | Y | Skip Logic | Phone or Tablet | |
| A tablet | X | |||||||||
| None of these | Mutually Exclusive | |||||||||
| HAR0074486 | W | Specifically, which type of smartphone do you have? | iPhone | Radio button, one-up vertical | Single | Y | Skip Logic | Phone Type | ||
| Android | ||||||||||
| Another phone | ||||||||||
| HAR0074487 | X | Specifically, which type of tablet do you have? | iPad | Radio button, one-up vertical | Single | Y | Skip Logic | Tablet Type | ||
| Kindle | ||||||||||
| Android | ||||||||||
| Another tablet | ||||||||||
| HAR0074488 | B | Have you ever accessed ANY federal website using a smartphone or tablet? | Yes | C | Radio button, one-up vertical | Single | Y | Skip Logic | Federal Mobile Site Usage | |
| No, but I plan to do so | ||||||||||
| No, but I might in the future | ||||||||||
| No, and I don't plan to do so | ||||||||||
| HAR0074489 | C | Have you ever accessed a VA medical center site using a smartphone or tablet? | Yes | Y, Z | Radio button, one-up vertical | Single | Y | Skip Logic | Mobile Site Usage | |
| No, but I plan to do so | Z | |||||||||
| No, but I might in the future | Z | |||||||||
| No, and I don't plan to do so | ||||||||||
| HAR0074491 | Y | What was the main reason you last visited a VA medical center site using a smartphone or tablet? | Text area, no char limit | Single | N | Skip Logic | Primary Reason | |||
| HAR0074492 | Z | What resources/additional resources might you want to access from a VA medical center site using a smartphone or tablet? | Text area, no char limit | Single | N | Skip Logic | Desired Resources | |||
| HAR0074490 | D | Have you ever accessed a VA Medical Center Social Media site (e.g. Facebook, Twitter, etc.) using a smartphone or tablet? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic | Mobile Social Media | ||
| No, but I plan to do so | ||||||||||
| No, but I might in the future | ||||||||||
| No, and I don't plan to do so | ||||||||||
| Have you ever accessed a VA Medical Center website while actually visiting a medical center location? (i.e. on a mobile device) | A | Radio button, one-up vertical | Single | Y | Skip Logic | Access on Location | ||||
| Yes | ||||||||||
| No | ||||||||||
| Not sure | ||||||||||
| A | Please explain the main reason you accessed the website while visiting the medical center. | Text area, no char limit | Single | N | Skip Logic | OE_Location | ||||
| MHM5857Q012 | How did you look for information on or navigate the site today? (Check all that apply) | Top navigation bar | L | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | How Look for Info | ||
| Links in the center of the page | L | Randomize | ||||||||
| Site map | L | |||||||||
| Search feature | M | |||||||||
| Other | L, N | Anchor Answer Choice | ||||||||
| MHM5857Q013 | N | How did you look for information or navigate the site? | Text area, no char limit | Single | N | Skip Logic Group* | OPS_How Look for Info | |||
| MHM5857Q014 | L | How would you describe your experience navigating the site today? (Check all that apply) | Links often did not take me where I expected | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | Navigation Experience | ||
| Links/labels are difficult to understand | ||||||||||
| Too many links/navigational options to choose from | ||||||||||
| Had technical difficulties (error messages, broken links, etc.) | ||||||||||
| Could not navigate back to previous information | ||||||||||
| I had another navigation difficulty | O | |||||||||
| I had no difficulty navigating on this site | Mutually Exclusive | |||||||||
| MHM5857Q015 | O | Please tell us about the difficulty you experienced navigating the site. | Text area, no char limit | Single | N | Skip Logic Group* | OPS_Navigation Experience | |||
| MHM5857Q016 | M | Please tell us about your experience with the site's search feature today. (Check all that apply) | I had issues with the basic search process (how to use it, terms to enter). | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | Search Experience | ||
| I had issues with the visual display of the search results (text size, images). | ||||||||||
| I had issues with the search results I received. | Z | |||||||||
| I had issues with sorting, filtering, advanced search, or lack of these options. | ||||||||||
| I had technical issues with the search feature. | P | |||||||||
| I had another search difficulty. | Q | |||||||||
| The search feature met my needs today. | Mutually Exclusive | |||||||||
| MHM5857Q017 | Q | Please tell us about the difficulty you experienced with the search feature. | Text area, no char limit | Single | N | Skip Logic Group* | OPS_Search Experience | |||
| MHM5857Q018 | P | Please explain the technical issue you experienced with search. | Text area, no char limit | Single | N | Skip Logic Group* | OE_Technical Issue | |||
| MHM5857Q019 | Z | What were your issues with the search results? (Check all that apply) | Results were not relevant/not what I wanted | Checkbox, one-up vertical | Multi | Y | Skip Logic Group* | Search Results Issue | ||
| There were not enough results | ||||||||||
| There were NO results | ||||||||||
| There was too little information in the results to decide what to choose | ||||||||||
| Many of the search results looked the same | ||||||||||
| I had another issue with the search results. | R | |||||||||
| MHM5857Q020 | R | Please explain the issue(s) you experienced with your search results. | Text area, no char limit | Single | N | Skip Logic Group* | OPS_Search Results Issue | |||
Sheet 5: Types
| Types | Instructions | |
| Text field, <100 char | Randomize | |
| Text area, no char limit | Shared | |
| Drop down, select one | OPS Group | |
| Radio button, one-up vertical | Matrix Group | |
| Radio button, two-up vertical | Rank Group | |
| Radio button, three-up vertical | Comparative Matrix Group | |
| Radio button, scale, has don't know | Skip Logic Group | |
| Radio button, scale, no don't know | Multiple Lists Group | |
| Checkbox, one-up vertical | Anchor Answer Choice | |
| Checkbox, two-up vertical | Partitioned | |
| Checkbox, three-up vertical | Adjust Template/Style Sheet | |
| Please Select a Language | Please Select | |
| Arabic - AR | Yes | |
| Australia - AU | No | |
| Belgium - BG | Unsure (PLEASE SEE DOT) | |
| Brazil Portuguese - BP | ||
| China - CH | ||
| Chinese Traditional - CT | ||
| Colombian - CO | ||
| Croatian - CR | ||
| Czech Republic - CZ | ||
| Danish - DN | ||
| Dutch - DU | ||
| English - EN | ||
| Farsi - FS | ||
| French - FR | ||
| French Canadian - FC | ||
| Germany - GR | ||
| Global English - GE | ||
| Greek - GK | ||
| Hungary - HU | ||
| Italian - IT | ||
| Japan - JP | ||
| Korean - KR | ||
| Malaysian English - MA | ||
| Mandarin - MD | ||
| Norwegian - NW | ||
| Persian - PN | ||
| Poland - PL | ||
| Portuguese - PO | ||
| Russia - RU | ||
| South Africa - SA | ||
| South Korean - SK | ||
| Spanish - SP | ||
| Spanish Original - SO | ||
| Spanish Traditional - ST | ||
| Swedish - SW | ||
| Turkey - TR | ||
| United Kingdom - UK | ||
| Vietnamese - VT | ||
| OTHER LANGUAGE (PLEASE SEE DOT) |
Sheet 6: Custom Qsts (7-2-15)
| 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 | Skip Logic | Visit Frequency | |||
| Frequently (about once a month or more often) | A, B | |||||||||
| Infrequently (Every few months or less often) | A,B | |||||||||
| ACQinh0025396 | A | We’ve recently redesigned our VA Medical Center websites. Please select the statement which best describes your experience with the redesign. | It is easier to find what I am looking for | Radio button, one-up vertical | Single | Y | Skip Logic | Redesign Ability to find | ||
| It is harder to find what I am looking for | ||||||||||
| My experience is no different when looking for information on the new site | ||||||||||
| Don't Know | ||||||||||
| ACQinh0025397 | B | Do you like the new layout of the medical center pages? | Yes | Radio button, one-up vertical | Single | Yes | Skip Logic | Opinion of Redesign | ||
| No | BB | |||||||||
| No Opinion | ||||||||||
| ACQinh0025398 | BB | What didn't you like about the new medical center pages? | Test area, no character limit | Single | N | Skip Logic | OE_Redesign | |||
| EDO03867 | Please tell us who you are. | Veteran | B | Radio button, one-up vertical | Single | Y | Skip Logic | Role | ||
| Active Duty | B | |||||||||
| Family Member / Friend | ||||||||||
| VA Employee | ||||||||||
| Volunteer | ||||||||||
| Healthcare Professional (MD, RN, etc.) | ||||||||||
| Job Applicant | ||||||||||
| Student / Healthcare Trainee | ||||||||||
| Media | ||||||||||
| Other | A | |||||||||
| EDO03868 | A | Please specify your other role. | Text area, no char limit | Single | N | Skip Logic | OE_Role | |||
| EDO03869 | B | Please check the conflict(s) in which you served. | World War II | Checkbox, one-up vertical | Multi | Y | Skip Logic | Conflict | ||
| Korean Conflict | ||||||||||
| Vietnam Era | ||||||||||
| Persian Gulf War | ||||||||||
| Operation Enduring Freedom | ||||||||||
| Operation Iraqi Freedom | ||||||||||
| Operation New Dawn | ||||||||||
| 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 | Skip Logic | 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 | S | Y | Skip Logic | Alaska | ||
| EDO03874 | B | Which Medical Center in Alabama do you visit? | Birmingham - Birmingham VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Alabama | ||
| 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 | S | Y | Skip Logic | Arkansas | ||
| 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 | S | Y | Skip Logic | Arizona | ||
| 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 | S | Y | Skip Logic | California | ||
| 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 | S | Y | Skip Logic | Colorado | ||
| 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 | S | Y | Skip Logic | Connecticut | ||
| 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 | S | Y | Skip Logic | DC | ||
| EDO03881 | I | Which Medical Center in Delaware do you visit? | Wilmington - Wilmington VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Delaware | ||
| EDO03882 | J | Which Medical Center in Florida do you visit? | Bay Pines - Bay Pines VA Healthcare System | Radio button, one-up vertical | S | Y | Skip Logic | Florida | ||
| 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 | S | Y | Skip Logic | Georgia | ||
| 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 | S | Y | Skip Logic | Hawaii | ||
| EDO03885 | M | Which Medical Center in Iowa do you visit? | Des Moines - VA Central Iowa Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Iowa | ||
| 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 | S | Y | Skip Logic | Idaho | ||
| EDO03887 | O | Which Medical Center in Illinois do you visit? | Chicago - Jesse Brown VA Medical Center | Radio button, one-up vertical | Illinois | |||||
| Danville - VA Illiana Health Care System | ||||||||||
| Hines - Edward Hines Jr. VA Hospital | ||||||||||
| Marion - Marion VA Medical Center | ||||||||||
| North Chicago – Captain James A. Lovell Federal Healthcare Center | ||||||||||
| EDO03888 | P | Which Medical Center in Indiana do you visit? | Fort Wayne - VA Northern Indiana Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Indiana | ||
| 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 | S | Y | Skip Logic | Kansas | ||
| 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 | S | Y | Skip Logic | Kentucky | ||
| Lexington - Lexington VA Medical Center (Leestown Division) | ||||||||||
| Louisville - Louisville VA Medical Center | ||||||||||
| EDO03891 | S | Which Medical Center in Louisiana do you visit? | New Orleans - Southeast Louisiana Veterans Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Louisiana | ||
| 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 | S | Y | Skip Logic | Massachusetts | ||
| Brockton - VA Boston Healthcare System | ||||||||||
| Jamaica Plain - VA Boston Healthcare System | ||||||||||
| Leeds – Central Western Massachusetts Health Care System | ||||||||||
| 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 | S | Y | Skip Logic | Maryland | ||
| 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 | S | Y | Skip Logic | Maine | ||
| EDO03895 | W | Which Medical Center in Michigan do you visit? | Ann Arbor - VA Ann Arbor Healthcare System | Radio button, one-up vertical | S | Y | Skip Logic | Michigan | ||
| 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 | S | Y | Skip Logic | Minnesota | ||
| 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 | S | Y | Skip Logic | Missouri | ||
| 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 | S | Y | Skip Logic | Mississippi | ||
| 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 | S | Y | Skip Logic | Montana | ||
| EDO03900 | BB | Which Medical Center in North Carolina do you visit? | Asheville - Asheville VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | North Carolina | ||
| 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 | S | Y | Skip Logic | North Dakota | ||
| EDO03902 | DD | Which Medical Center in Nebraska do you visit? | Omaha - VA Nebraska-Western Iowa Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Nebraska | ||
| EDO03903 | EE | Which Medical Center in New Hampshire do you visit? | Manchester - Manchester VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | New Hampshire | ||
| EDO03904 | FF | Which Medical Center in New Jersey do you visit? | East Orange - VA New Jersey Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | New Jersey | ||
| 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 | S | Y | Skip Logic | New Mexico | ||
| EDO03906 | HH | Which Medical Center in Nevada do you visit? | Las Vegas - VA Southern Nevada Healthcare System | Radio button, one-up vertical | Nevada | |||||
| 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 | S | Y | Skip Logic | New York | ||
| 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 | S | Y | Skip Logic | Ohio | ||
| 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 | S | Y | Skip Logic | Oklahoma | ||
| 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 | S | Y | Skip Logic | Oregon | ||
| Portland - Portland VA Medical Center | ||||||||||
| EDO03911 | MM | Which Medical Center in Pennsylvania do you visit? | Altoona - James E. Van Zandt VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Pennsylvania | ||
| 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) | ||||||||||
| Pittsburgh - VA Pittsburgh Healthcare System (H.J. Heinz Progressive Care Center) | ||||||||||
| 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 | S | Y | Skip Logic | Puerto Rico | ||
| EDO03913 | OO | Which Medical Center in Rhode Island do you visit? | Providence - Providence VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Rhode Island | ||
| EDO03914 | PP | Which Medical Center in South Carolina do you visit? | Charleston - Ralph H. Johnson VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | South Carolina | ||
| 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 | S | Y | Skip Logic | South Dakota | |||
| 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 | S | Y | Skip Logic | Tennessee | ||
| 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 | S | Y | Skip Logic | Texas | ||
| 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 | S | Y | Skip Logic | Utah | ||
| EDO03919 | UU | Which Medical Center in Virginia do you visit? | Hampton - Hampton VA Medical Center | Radio button, one-up vertical | S | Y | Skip Logic | Virginia | ||
| 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 | S | Y | Skip Logic | Vermont | ||
| EDO03921 | WW | Which Medical Center in Washington do you visit? | Seattle - VA Puget Sound Health Care System | Radio button, one-up vertical | S | Y | Skip Logic | Washington | ||
| 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 | S | Y | Skip Logic | Wisconsin | ||
| 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 | S | Y | Skip Logic | West Virginia | ||
| 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 | S | Y | Skip Logic | Wyoming | ||
| 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 | OPS Group | Type of Information Seeking | |||
| 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 | A | |||||||||
| EDO03926 | A | Please specify the information you were trying to find. | OPS Group | OE_Reason | ||||||
| EDO03927 | Did you find what you were looking today? | Yes | Radio button, one-up vertical | Single | Y | OPS Group | Find Info | |||
| No, I was looking for: | A | |||||||||
| EDO03928 | A | What specific information were you unable to find? | OPS Group | OE_Find | ||||||
| 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 | Skip Logic | Services Adequate | |||
| No | A | |||||||||
| EDO03934 | A | Why not? | Text area, no char limit | Skip Logic | 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 | OPS Group | 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 | A | |||||||||
| EDO03936 | A | Please specify how you first heard about this site. | OPS Group | 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 | Skip Logic | 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 | Checkbox, one-up vertical | Multi | Y | Skip Logic | How Add Info | ||
| Social Networking (Facebook, Twitter, etc.) | ||||||||||
| RSS | ||||||||||
| SMS / Text Messaging | ||||||||||
| EDO03931 | Do you use MyHealtheVet (prescription refills, personal health record, etc.)? | Yes | A | Radio button, one-up vertical | Single | Y | Skip Logic | MHV Usage | ||
| No | B | |||||||||
| EDO03939 | A | Have you completed the In-Person Authentication (IPA) which allows you to view the names of your prescriptions, view lab test results, and see your upcoming appointments? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic | IPA | ||
| No | ||||||||||
| EDO03932 | B | Why not? | Text area, no char limit | Single | N | Skip Logic | OE_Not Use MHV | |||
| EDO03929 | Do you use any of the following while on the Internet? (Check all that apply) | Checkbox, one-up vertical | Multi | Y | Skip Logic | Social media | ||||
| MySpace | ||||||||||
| YouTube | ||||||||||
| Google+ | ||||||||||
| Foursquare | ||||||||||
| Yelp | ||||||||||
| Flickr | ||||||||||
| Blogs | ||||||||||
| Del.icio.us | ||||||||||
| Digg | ||||||||||
| Podcasts | ||||||||||
| I do not use any of these social media tools. | 8889 | |||||||||
| Other | A | |||||||||
| EDO03930 | A | Please specify other social media sites you use. | Text area, no char limit | Skip Logic | OE_Social Media | |||||
| HAR0074484 | Do you ever access the Internet using a mobile phone or tablet? | Yes | A, B, D | Radio button, one-up vertical | Single | Y | Skip Logic | Access Mobile Internet | ||
| No | ||||||||||
| HAR0074485 | A | Which of the following devices do you have? | A SmartPhone | W | Checkbox, one-up vertical | Multi | Y | Skip Logic | Phone or Tablet | |
| A tablet | X | |||||||||
| None of these | Mutually Exclusive | |||||||||
| HAR0074486 | W | Specifically, which type of smartphone do you have? | iPhone | Radio button, one-up vertical | Single | Y | Skip Logic | Phone Type | ||
| Android | ||||||||||
| Blackberry | ||||||||||
| Another phone | ||||||||||
| HAR0074487 | X | Specifically, which type of tablet do you have? | iPad | Radio button, one-up vertical | Single | Y | Skip Logic | Tablet Type | ||
| Kindle | ||||||||||
| Android | ||||||||||
| Blackberry | ||||||||||
| Another tablet | ||||||||||
| HAR0074488 | B | Have you ever accessed ANY federal website using a smartphone or tablet? | Yes | C | Radio button, one-up vertical | Single | Y | Skip Logic | Federal Mobile Site Usage | |
| No, but I plan to do so | ||||||||||
| No, but I might in the future | ||||||||||
| No, and I don't plan to do so | ||||||||||
| HAR0074489 | C | Have you ever accessed a VA medical center site using a smartphone or tablet? | Yes | Y, Z | Radio button, one-up vertical | Single | Y | Skip Logic | Mobile Site Usage | |
| No, but I plan to do so | Z | |||||||||
| No, but I might in the future | Z | |||||||||
| No, and I don't plan to do so | ||||||||||
| HAR0074491 | Y | What was the main reason you last visited a VA medical center site using a smartphone or tablet? | Text area, no char limit | Single | N | Skip Logic | Primary Reason | |||
| HAR0074492 | Z | What resources/additional resources might you want to access from a VA medical center site using a smartphone or tablet? | Text area, no char limit | Single | N | Skip Logic | Desired Resources | |||
| HAR0074490 | D | Have you ever accessed a VA Medical Center Social Media site (e.g. Facebook, Twitter, etc.) using a smartphone or tablet? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic | Mobile Social Media | ||
| No, but I plan to do so | ||||||||||
| No, but I might in the future | ||||||||||
| No, and I don't plan to do so | ||||||||||
Sheet 7: Custom Qsts (12-13-10)
| 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 Pennsylvania 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) | ||||||||||
| Pittsburgh - VA Pittsburgh Healthcare System (H.J. Heinz Progressive Care Center) | ||||||||||
| 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 | |||||||
| 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 | Checkbox, one-up vertical | Multi | Y | How Add Info | |||
| Social Networking (Facebook, Twitter, etc.) | ||||||||||
| RSS | ||||||||||
| SMS / Text Messaging | ||||||||||
| 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 | ||||||
| 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 | ||||||||||
| I do not use any of these social media tools. | ||||||||||
| Other, please specify: | A | |||||||||
| EDO03930 | A | Other, please specify: | Text area, no char limit | OE_Social Media | ||||||
Sheet 8: Custom Qsts (1-19-15)
| 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 | Visit Frequency | ||||
| Frequently (about once a month or more often) | A, B | |||||||||
| Infrequently (Every few months or less often) | A,B | |||||||||
| ACQinh0025396 | A | We’ve recently redesigned our VA Medical Center websites. Please select the statement which best describes your experience with the redesign. | It is easier to find what I am looking for | Radio button, one-up vertical | Single | Y | Skip Logic | Redesign Ability to find | ||
| It is harder to find what I am looking for | ||||||||||
| My experience is no different when looking for information on the new site | ||||||||||
| Don't Know | ||||||||||
| ACQinh0025397 | B | Do you like the new layout of the medical center pages? | Yes | Radio button, one-up vertical | Single | Yes | Skip Logic | Opinion of Redesign | ||
| No | BB | |||||||||
| No Opinion | ||||||||||
| ACQinh0025398 | BB | What didn't you like about the new medical center pages? | Test area, no character limit | N | Skip Logic | OE_Redesign | ||||
| 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 | ||||||||||
| Operation New Dawn | ||||||||||
| 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 – Captain James A. Lovell Federal Healthcare 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 – Central Western Massachusetts Health Care System | ||||||||||
| 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 Pennsylvania 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) | ||||||||||
| Pittsburgh - VA Pittsburgh Healthcare System (H.J. Heinz Progressive Care Center) | ||||||||||
| 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 | |||||||
| 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 | Checkbox, one-up vertical | Multi | Y | How Add Info | |||
| Social Networking (Facebook, Twitter, etc.) | ||||||||||
| RSS | ||||||||||
| SMS / Text Messaging | ||||||||||
| 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, view lab test results, and see your upcoming appointments? | Yes | Radio button, one-up vertical | Single | Y | IPA | |||
| No | ||||||||||
| EDO03932 | B | Why not? | Text area, no char limit | OE_Not Use MHV | ||||||
| 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 | ||||||||||
| Google+ | ||||||||||
| Foursquare | ||||||||||
| Yelp | ||||||||||
| Flickr | ||||||||||
| Blogs | ||||||||||
| Del.icio.us | ||||||||||
| Digg | ||||||||||
| Podcasts | ||||||||||
| I do not use any of these social media tools. | 8889 | |||||||||
| Other, please specify: | A | |||||||||
| EDO03930 | A | Other, please specify: | Text area, no char limit | OE_Social Media | ||||||
| ACQhar0018234 | Do you ever access the Internet using a mobile phone or tablet? | Yes | A, B, D | Radio button, one-up vertical | Single | Y | Access Mobile Internet | |||
| No | ||||||||||
| ACQhar0018235 | A | Which of the following devices do you have? | A SmartPhone | W | Radio button, one-up vertical | Multi | Y | Phone or Tablet | ||
| A tablet | X | |||||||||
| None of these | ||||||||||
| ACQhar0018237 | W | Specifically, which type of smartphone do you have? | iPhone | Radio button, one-up vertical | Single | Y | Phone Type | |||
| Android | ||||||||||
| Blackberry | ||||||||||
| Another phone | ||||||||||
| ACQhar0018238 | X | Specifically, which type of tablet do you have? | iPad | Radio button, one-up vertical | Single | Y | Tablet Type | |||
| Kindle | ||||||||||
| Android | ||||||||||
| Blackberry | ||||||||||
| Another tablet | ||||||||||
| ACQhar0018236 | B | Have you ever accessed ANY federal website using a smartphone or tablet? | Yes | C | Radio button, one-up vertical | Single | Y | Federal Mobile Site Usage | ||
| No, but I plan to do so | ||||||||||
| No, but I might in the future | ||||||||||
| No, and I don't plan to do so | ||||||||||
| ACQhar0018239 | C | Have you ever accessed a VA medical center site using a smartphone or tablet? | Yes | Y, Z | Radio button, one-up vertical | Single | Y | Mobile Site Usage | ||
| No, but I plan to do so | Z | |||||||||
| No, but I might in the future | Z | |||||||||
| No, and I don't plan to do so | ||||||||||
| ACQinh0018956 | D | Have you ever accessed a VA Medical Center Social Media site (e.g. Facebook, Twitter, etc.) using a smartphone or tablet? | Yes | Radio button, one-up vertical | Single | Y | Mobile Social Media | |||
| No, but I plan to do so | ||||||||||
| No, but I might in the future | ||||||||||
| No, and I don't plan to do so | ||||||||||
| ACQhar0018205 | Y | What was the main reason you last visited a VA medical center site using a smartphone or tablet? | Text area, no char limit | Single | N | Primary Reason | ||||
| ACQhar0018206 | Z | What resources/additional resources might you want to access from a VA medical center site using a smartphone or tablet? | Text area, no char limit | Single | N | Desired Resources | ||||
Sheet 9: Custom Qsts (4-10-13)
| 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 | Visit Frequency | ||||
| Frequently (about once a month or more often) | A, B | |||||||||
| Infrequently (Every few months or less often) | A,B | |||||||||
| A | We’ve recently redesigned our VA Medical Center websites. Please select the statement which best describes your experience with the redesign | It is easier to find what I am looking for | Checkbox, one-up vertical | Single | Y | Skip Logic | Redesign Ability to find | |||
| It is harder to find what I am looking for | ||||||||||
| My experience is no different when looking for information on the new site | ||||||||||
| Don't Know | ||||||||||
| B | Do you like the new layout of the medical center pages? | Yes | Single | Yes | Skip Logic | Opinion of Redesign | ||||
| No | BB | |||||||||
| No Opinion | ||||||||||
| BB | What didn't you like about the new medical center pages? | Test area, no character limit | N | Skip Logic | OE_Redesign | |||||
| 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 | ||||||||||
| Operation New Dawn | ||||||||||
| 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 -> North Chicago – Captain James A. Lovell Federal Healthcare 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 -> Leeds – Central Western Massachusetts Health Care System | ||||||||||
| 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 Pennsylvania 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) | ||||||||||
| Pittsburgh - VA Pittsburgh Healthcare System (H.J. Heinz Progressive Care Center) | ||||||||||
| 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 | |||||||
| 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 | Checkbox, one-up vertical | Multi | Y | How Add Info | |||
| Social Networking (Facebook, Twitter, etc.) | ||||||||||
| RSS | ||||||||||
| SMS / Text Messaging | ||||||||||
| 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, view lab test results, and see your upcoming appointments? | Yes | Radio button, one-up vertical | Single | Y | IPA | |||
| No | ||||||||||
| EDO03932 | B | Why not? | Text area, no char limit | OE_Not Use MHV | ||||||
| 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 | ||||||||||
| Google+ | ||||||||||
| Foursquare | ||||||||||
| Yelp | ||||||||||
| Flickr | ||||||||||
| Blogs | ||||||||||
| Del.icio.us | ||||||||||
| Digg | ||||||||||
| Podcasts | ||||||||||
| I do not use any of these social media tools. | 8889 | |||||||||
| Other, please specify: | A | |||||||||
| EDO03930 | A | Other, please specify: | Text area, no char limit | OE_Social Media | ||||||
Sheet 10: Custom Qsts (8-16-10)
| 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) | ||||||||||
| Pittsburgh - VA Pittsburgh Healthcare System (H.J. Heinz Progressive Care Center) | ||||||||||
| 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 | |||||||
| 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 | Checkbox, one-up vertical | Single | Y | How Add Info | |||
| Social Networking (Facebook, Twitter, etc.) | ||||||||||
| RSS | ||||||||||
| SMS / Text Messaging | ||||||||||
| 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 | ||||||
| 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 | ||||||
Sheet 11: 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 Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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