Main Page Navigation
 
 
 
 
 
 
 
 
 
How often do you go to your doctor ?
   
  1. Once a year
   
   
  2. Twice a year
   
   
  3. Regularly
   
   
  4. Frequently
   
 
 
  Does your doctor work well with you?
   
  1. Definitely
.
 
2. Somewhat
   
   
  3. Not really
   
   
  4. No
   
 
 
  Do you prefer to have an interpreter when you see your doctor?
   
  1. Yes! I must have an interpreter
.
 
2. An interpreter would be nice
   
   
  3. It doesn't matter
   
   
  4. I don't want an interpreter for my doctor
   
 
 
  Does your doctor hire an interpreter for you?
   
  1. Yes, always
.
 
2. Often
   
   
  3. Once in a while
   
   
  4. Never
   
 
 
  Does your doctor hire certified interpreter?
   
  1. Yes, always
.
 
2. Often
   
   
  3. Once in a while
   
   
  4. Never
   
 
 
  Are you satisfied with an interpreter the doctor hired?
   
  1. Oh yes!
.
 
2. Somewhat
   
   
  3. Not really
   
   
  4. No
   
 
 
  After seeing your doctor, do you understand their instructions?
   
  1. Yes, I understand
.
 
2. I understand mostly
   
   
  3. I am confused often
   
   
  4. I don't understand at all
   
 
 
  Do you tell your doctor your rights to have an interpreter?
   
  1. Yes, I do!
.
 
2. Yes, maybe
   
   
  3. I prefer not to tell
   
   
  4. Never
   
 
   
Title (Ms.,Mr.):
First Name:
Last Name:
Title:
Organization:
Web:
Street Address:
City:
State:
Zip:
Daytime Phone:
Fax:
Email:
Repeat Email:
Register:

We respect your privacy and will not give your information to solicitors.

About Us Home News About Us Search Donate Our Sponsors Site Map Contact HSDC United Way About Our New Bellingham Office Contact Seattle Coming soon!!
For You For Your Business For Your Community For Your Parent For Your Child For Your Patient