Dillon County Provider Survey - McLeod Health

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Dillon County Provider Survey

We want to hear your thoughts about important health issues in the community you serve. We will use the results of this short survey and other information to help improve health programs in our area. Thank you for your participation.

Click on the button below to complete the survey.

Dillon County Provider Survey

Please complete the survey below. Thank you.
Section 1
Please check the categories that best describe your agency. (Check all that apply)
- Community-Based Organization
- Community Health Center
- Dental Practice
- Home Care Agency
- Hospital
- Medical Practice
- Mental Health Clinic
- Outpatient Clinic
- Other
Other
Other:
Section 2
Please check the types of services provided by your agency. (Check all that apply)
- Breastfeeding Support
- Dental Services
- Childcare
- Community Education
- Domestic Violence Prevention
- Drug/Alcohol Services
- Elder Care/Senior Services
- Exercise/Weight Loss Programs
- Family Planning
- Health Insurance Enrollment
- Health Screenings
- Home Care Services
- Immigrant Support Services
- Mental Health Services
- Prenatal/PCAP Services
- Primary Care Services – Adult
- Primary Care Services – Children
- Smoking/Tobacco Services
- Transportation
- Violence/Bullying/Gang Prevention
- WIC
- Other
Other
Other:
Section 3
Please check all persons served by your agency (Check all that apply)
- Adults
- Children
- Disabled
- Immigrants
- Low-income
- Uninsured
- Other
Other
Other:
Section 4
What are the THREE biggest ongoing health concerns for the people/community you serve?
- Access to Primary Health Care
- Access to Specialty Care
- Alcohol Abuse
- Asthma/Breathing Problems
- Cancer
- Care for the Elderly
- Child Health & Wellness
- Dementia/Alzheimer’s
- Dental Care
- Diabetes
- Disability
- Distracted Driving
- Drug Abuse
- Family Planning/Teen Pregnancy
- Healthy Environment
- Heart Disease/Stroke
- HIV/AIDS & Sexually Transmitted Infections
- Mental Health/Depression/Suicide
- Nutrition/Eating Habits
- Overweight/Obesity
- Preventable Injury/Falls
- Smoking/Tobacco Use
- Violence
- Women’s Health
- Other
Other
Other:
Section 5
What THREE things would be most helpful to improve health problems of the people/community you serve?
- Access to Healthier Food
- Affordable Housing
- Breastfeeding Support
- Caregiver Support
- Clean Air & Water
- Community Education
- Dental Services
- Domestic Violence Prevention
- Drug/Alcohol Services
- Elder Care Services
- Exercise/Weight Loss Programs
- Health Insurance Enrollment
- Health Screenings
- Home Care Services
- Immigrant Support Services
- Job Opportunities
- Mental Health Services
- Safer Childcare Options
- Safer Places to Walk/Play
- Smoking/Tobacco Services
- Transportation
- Violence/Bullying/Gang Prevention
- Other
Other
Other:
Section 6
How would you rate the health of the people/community you serve?
- Very Healthy
- Healthy
- Somewhat Healthy
- Unhealthy
- Very Unhealthy
Section 7
What are the THREE most significant barriers impacting YOUR ability to provide services to your patients/clients?
- Cultural Competency Issues
- High No-Show Rate
- Inadequate Insurance Reimbursement
- Lack of Funding
- Limited Bi-Lingual Staff
- Limited of Lack of Access to Specialists
- Limited Space and/or Equipment
- Limited Staffing Resources
- Patient cannot afford Prescription Medicines
- Patient Non-Adherence to Treatment
- Other
Other
Other:
Section 8
For the patients/clients you serve, what are the top THREE barriers impacting your clients’ ability to access services?
- There Are No Issues
- Cannot Afford Services
- Co-Pay/Deductible Too High
- Cultural/Religious Beliefs
- Do not like going/Afraid To Go
- Do not understand need to see a Provider
- Inconvenient Office Hours
- Insurance Does Not Cover Service
- Lack of Time
- Lack or Limited Providers/Service
- Lack or Limited Providers who speak their language
- No Transportation/Too Far
- No Childcare
- No Insurance
- Other
Other
Other:
Section 9
Where do community members you serve get most of their health information? (Check all that apply)
- Community-Based Organization
- Doctor/Health Professional
- Family or Friends
- Health Department
- Hospital
- Internet
- Library
- Newspaper/Magazine
- Radio
- Religious Organization
- School/College
- Social Media (Facebook, Twitter, etc.)
- Television
- Worksite
Zip code where you work:
Zip code where you work:
Section 10
How would you best describe your title/role in your agency?
- Advocate
- Alcohol/Substance Counselor
- Board Member
- Dentist
- Executive Director
- Health Educator
- Nurse
- Physician
- Program Administrator/Manager
- Psychologist
- Social Worker
- Other
Other
Other:
Optional
Your Name
Your Name:
Phone Number
Phone Number:
Title
Title:
Agency
Agency:
Email Address
Email Address:
Email
This field is for validation purposes and should be left unchanged.

10904

McLEOD REGIONAL MEDICAL CENTER FLORENCE
843-777-2000
McLEOD DARLINGTON
843-777-1100
McLEOD DILLON
843-774-4111
McLEOD LORIS
843-716-7000
McLEOD SEACOAST
843-390-8100
McLEOD CHERAW
843-537-7881
McLEOD CLARENDON
803-433-3000

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McLEOD REGIONAL MEDICAL CENTER FLORENCE
843-777-2000
McLEOD DARLINGTON
843-777-1100
McLEOD DILLON
843-774-4111
McLEOD LORIS
843-716-7000
McLEOD SEACOAST
843-390-8100
McLEOD CHERAW
843-537-7881
McLEOD CLARENDON
803-433-3000

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