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