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| # | Location | File | Last Modified |
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| 1 | HTRE_P3_v14.5_iter_4_build_14.zip\webapp\docs | PatSatSurveyV2.doc | Wed May 29 15:26:14 2019 UTC |
| 2 | HTRE_P3_v14.5_iter_4_build_14.zip\webapp\docs | PatSatSurveyV2.doc | Tue Jun 11 11:52:51 2019 UTC |
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| 2 | “It is imp ortant to know what you think about the Home Teleh ealth pro gram. Ple ase answer the follo wing eight questions . The OMB survey app roval numb er is 2900 -0766. ” | |
| 3 | **Notes: | |
| 4 | The number s in paren theses are how the r esponse wi ll be scor ed in the database. | |
| 5 | Home Teleh ealth Pati ent Satisf action Que stionnaire Content: | |
| 6 | 1. My car e coordina tor explai ns things in a way t hat is eas y to under stand. | |
| 7 | Always (1) | |
| 8 | Usually (2 ) | |
| 9 | Sometimes (3) | |
| 10 | Never (4) | |
| 11 | 2. The inf ormation p rovided by my care c oordinator has helpe d me manag e my healt h problem( s). | |
| 12 | Strongly A gree (1) | |
| 13 | Agree (2) | |
| 14 | Disagree ( 3) | |
| 15 | Strongly D isagree (4 ) | |
| 16 | 3. Over th e past 3 m onths, my home teleh ealth equi pment work s: | |
| 17 | Always (1) | |
| 18 | Usually (2 ) | |
| 19 | Sometimes (3) | |
| 20 | Never (4) | |
| 21 | 4. My home telehealt h equipmen t is easy to use. | |
| 22 | Strongly A gree (1) | |
| 23 | Agree (2) | |
| 24 | Disagree ( 3) | |
| 25 | Strongly D isagree (4 ) | |
| 26 | 5. I have made chang es in the way I take care of m yself as a result of the VA ho me telehea lth progra m. | |
| 27 | Strongly A gree (1) | |
| 28 | Agree (2) | |
| 29 | Disagree ( 3) | |
| 30 | Strongly D isagree (4 ) | |
| 31 | 6. When I have quest ions, I am able to c ontact my care coord inator dur ing busine ss hours. | |
| 32 | Always (1) | |
| 33 | Usually (2 ) | |
| 34 | Sometimes (3) | |
| 35 | Never (4) | |
| 36 | 7. Using t he VA home telehealt h program has made a positive difference in my hea lth. | |
| 37 | Strongly A gree (1) | |
| 38 | Agree (2) | |
| 39 | Disagree ( 3) | |
| 40 | Strongly D isagree (4 ) | |
| 41 | 8. I would recommend a home te lehealth p rogram to others. | |
| 42 | Strongly A gree (1) | |
| 43 | Agree (2) | |
| 44 | Disagree S trongly (3 ) | |
| 45 | Disagree ( 4) |
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