Web Site Survey

1
How did you find our Web site? (Check all that apply.)
I was referred by my doctor or a healthcare provider in my doctor's office
I was linked to it through another Web site
I was referred by a friend or family member
I saw/heard of the Web site in promotional material used by the hospital
I used a search engine and typed in the hospital's name
I am an employee of the hospital
Other, please specify
2
What information were you looking for on our Web site? (Check all that apply.)
Address/directions to the hospital
Services provided by the hospital
To find a physician to meet my healthcare needs
Information on a physician to whom I have been referred
Specific health condition or disease
Classes offered by the hospital
Jobs and careers
Clinical trials
Medical education opportunities
Other, please specify
3
Should we add more information about any of the following topics to the site? (Check all the topics that you would like to see expanded.)
Specific illnesses or conditions
Specific diagnostic or treatment procedures
Clinical trials at the University of Chicago Hospitals
Wellness, fitness, or nutrition programs
University of Chicago physicians
Classes, screenings, or support groups
Other, please specify
4
What else would you like to see or do on this site?
Receive an e-mail newsletter about medical topics of interest
"Ask an Expert" about a medical topic of interest
E-mail a physician
Pay a medical bill
Schedule a procedure
Complete a pre-admission form
View a video on a medical topic of interest
Develop a personal health page
Send a gift to a patient
Other, please specify
5
What recommendations could you make that would improve our Web site's value to you?
6
Age (Optional)
Less than 18
18 - 34
35 - 49
50 - 64
Over 65
7
Gender (Optional)
Female
Male
8
5-digit zip code (Optional)