Telehealth Needs Assessment

Telehealth Needs Assessment

Family Voices of Tennessee and the Tennessee Department of Health want to learn about you and your child's experience using telehealth (healthcare appointments by video or phone). They will use this information to create resources and recommendations for improving telehealth services for children with disabilities. By answering these 12 questions in this survey, you will be entered to win a $25 dollar Amazon gift card. We will randomly select 4 winners and notify you via email if you are selected. If you need accommodations to complete this survey, please email: chrissy_h@tndisability.org
1. What is your email address? *
example@example.com
Demographic Information
2. Choose all that apply. Do you take care of a child who:*

Has a disabilityHas long-term or chronic health conditionsNeeds special medical care
3. What county in Tennessee do you live in? *
Access to Broadband Connection
4. Do you have access to internet to participate in a telehealth appointment from your home or cell phone?

YesNo
Telehealth Knowledge

Telehealth (sometimes called Telemedicine) lets your health care provider care for you without an in-person office visit. Telehealth is done primarily online with internet access on your computer, tablet, or smartphone.
5. Since 2020, how many times have you used telehealth/telemedicine services for your child with a disability/complex medical need?*

01-5More than 5
6. Do you feel comfortable using your phone/computer/device for a telehealth appointment?*

YesNo
7. Do you know how to find a solution for technical problems (like your camera or microphone not working) if they happen during a telehealth appointment?*

YesNoNot sureIt depends
8. Would you be interested in additional training around navigating telehealth appointments?*

YesNoNot sureIt depends
The Role of Your Provider
9. Did your provider inform you about your telehealth options or did you request it?*

Provider offered telehealth as an option for my child's appointment.I requested telehealth as an option for my child's appointment.
10. What could your provider do to improve your telehealth experience? *
11. Do you think telehealth is good for your child? Why or why not? *
12. In the next 12 months do you expect to:*

Use telehealth more often than last yearUse telehealth less often than last yearUse telehealth about the same
Thank you for your willingness to participate in this survey.
Should be Empty: