PNWBD Customer Service & Program Survey

PNWBD Customer Service & Program Survey

Please take a moment to fill out this survey to improve PNWBD's role in your community
PNWBD Program & Event Evaluation

Please answer the following based on your experience at educational, fundraising, camps and connecting events.
Select the programs you are aware of:*

Connection Meetings (Portland, Eugene, Southern Oregon and/or Hispanic)Advocacy Awareness Day at the State CapitalTeen Peak ProgramBlood BrotherhoodCouples RetreatUnite for Bleeding Disorders WalkFamily CampSummer Camp for Kids (Camp Tapawingo)Annual Meeting/Education Day at the ZooInsurance ForumShooting for the Stars AuctionWomen's ConferenceParking Lot SaleWinter CelebrationPatient Assistance
Select the programs you or a family member have attended in the past year:*

Connection Meetings (Portland, Eugene, Southern Oregon and/or Hispanic)Advocacy Awareness Day at the State CapitalTeen Peak ProgramBlood BrotherhoodCouples RetreatUnite for Bleeding Disorders WalkFamily CampSummer Camp for Kids (Camp Tapawingo)Annual Meeting/Education Day at the ZooInsurance ForumShooting for the Stars AuctionWomen's ConferenceParking Lot SaleWinter CelebrationPatient Assistance
Select your TOP 3 MOST IMPORTANT programs:*

Connection Meetings (Portland, Eugene, Southern Oregon and/or Hispanic)Advocacy Awareness Day at the State CapitalTeen Peak ProgramBlood BrotherhoodCouples RetreatUnite for Bleeding Disorders WalkFamily CampSummer Camp for Kids (Camp Tapawingo)Annual Meeting/Education Day at the ZooInsurance ForumShooting for the Stars AuctionWomen's ConferenceParking Lot SaleWinter CelebrationPatient Assistance
Select 1 - 3 programs you would be willing to cut:*

Connection Meetings (Portland, Eugene, Southern Oregon and/or Hispanic)Advocacy Awareness Day at the State CapitalTeen Peak ProgramBlood BrotherhoodCouples RetreatUnite for Bleeding Disorders WalkFamily CampSummer Camp for Kids (Camp Tapawingo)Annual Meeting/Education Day at the ZooInsurance ForumShooting for the Stars AuctionWomen's ConferenceParking Lot SaleWinter CelebrationPatient Assistance
Select the best option that describes how you feel about the PNWBD programming?*

Very PositiveSomewhat NegativeSomewhat PositiveVey Negative
Please explain the reason for your selection above.
What are the reasons you choose your top 3 most important programs? *
Are there any barriers that prevent you from participating more in the programs that PNWBD offers?
What other programs and/or education would you like to see provided by PNWBD?
Which programs would you be willing to volunteer at?*

Advocacy Awareness DayAnnual MeetingCouples RetreatSummer Camp for KidsFamily CampTeem Peak ProgramWomen's ConferenceUnite WalkShooting for the StarsPNWBD Garage SaleWinter CelebrationI do not wish to volunteerOther
Communication from PNWBD

Please answer the following based on the communication you receive from PNWBD
Please select if you receive the following mailing:*

Emails (events/updates)USPS Mailers (events/updates)USPS NewsletterDigital Newsletter
Is there a better way for the PNWBD to communicate with members?
PNWBD Overall

Please answer the following on how you feel about PNWBD and how we can improve.
How do you rate PNWBD’s ability to support the bleeding disorder community? (Range: 1 Star=Needs improvement to 5 Stars=Meets/Exceeds Expectations)?*
What are your or your family’s needs that PNWBD could support in the future?
How can PNWBD improve in the future?
Bleeding Disorder Care Team

Please answer the following questions to help your bleeding disorder care team serve you better.
Where do you or your household go for regular medical care related to bleeding disorders?*

HTC at Oregon Health and Science UniversityPrimary care providerPrefer not to answerOther
If you chose primary care provider or other for your bleeding disorder care please explain.
i.e. the medical group or hospital care is received
Are there other services that you would like to see from your bleeding disorder care team?
Are there needs that are not being met by your bleeding disorder care team?
Demographic Information

Please tell us about yourself!
Select the range that includes your age*
Select the race or ethnicity that best describes you? *
Select the gender you identify with*

MaleFemaleNon-BinaryPrefer not to answerOther:
Select the best option that describes the type of community/area you live in?*

RuralUrbanSuburbanPrefer not to answerOther:
Select all that apply to your household/family*

Hemophilia AHemophilia BHemophilia 5Hemophilia 10Hemophilia 13VWB Type 1VWB Type 2VWB Type 3Platelet DisorderInhibitorsHemophilia CarrierCaregiverPrefer not to answerOther
Should be Empty:

PNWBD Customer Service & Program Survey

PNWBD Program & Event Evaluation

Communication from PNWBD

PNWBD Overall

Bleeding Disorder Care Team

Demographic Information