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128th District Health Survey

What is your zip code?
What kind of health Insurance do you currently have?
Private Insurance
Public Insurance (ex-Medicaid, Medicare, VA)
I do not have insurance
Do you believe your health care is affordable?
Yes
No
I do not have insurance
If you are currently uninsured ,please choose one of the following reasons as to why?
Too expensive
I do not know where to get health insurance
I already have Health Insurance
N/A
Are you able to pay your current medical bills?
Yes
No
N/A
Do you believe it is the government’s responsibility to make sure all Americans have healthcare coverage?
Yes
No
Have you used telehealth services since March 2020?
Yes
No
If so, were you satisfied with the quality of the service?
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
N/A
If so, did you feel that your current mobile technology and internet bandwidth for connecting to telehealth services was sufficient?
Yes
No
N/A
If so, do you plan to continue to use telehealth services after it is no longer necessary due to the pandemic?
Likely
Neither likely nor unlikely
Unlikely
N/A
What are your biggest concerns currently regarding COVID-19? Check all that apply:
Contracting COVID-19
Transmitting COVID-19 to friends and/or family with comorbidities
Nursing home safety
Economic impact and job security
State budget cuts
Access to PPE
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