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COMMUNITY OUTREACH & ENGAGEMENT SURVEY
new Lyndon B. Johnson Hospital
Your thoughts, needs and concerns are the most important piece to the design of the new Lyndon B. Johnson (LBJ) Hospital Project. This survey will guide the design and project teams' process. We will not share or sell your personal information with anyone outside of our team or for marketing purposes of any sort.
Event Name
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What is your age range?
18 - 35
36 - 55
56 +
Prefer not to answer
Which best describes you?
Male
Female
Prefer not to answer
Which best describes you? (Check all that apply)
African American
Hispanic
White
Asian Pacific
Prefer not to answer
Other
Which community do you live in?
Acres Homes
Greenspoint
Fifth Ward
Kashmere Gardens
Trinity Gardens
Denver Harbor
Northshore
Not a Harris County Resident
Other
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Which best describes you? (Check all that apply)
Patient of LBJ Services
Friend or Family Member of LBJ Patient
Resident Near LBJ
LBJ Employee/Vendor
Interested in Vendor Opportunities
Community Leader
Press/Media Personnel
Prefer not to answer
Other
Have you visited LBJ Hospital?
Yes
No
Which of the following best described how you felt about your last visit?
Very Satisfied
Satisfied
Neither Satisfied nor Dissatisfied
Dissatisfied
Very Dissatisfied
Please confirm what area(s) you visited: (Check all that apply)
Emergency Department
ICU
Oncology
Mother/Baby
In-patient Surgery
Food Pharmacy
Other
Tell us about your experience when you last visited the LBJ Hospital.
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How do you feel about building a new LBJ Hospital?
Strongly Agree
Agree
Neither Agree nor Disagree
Disagree
Strongly Disagree
How did you first learn about the new LBJ Hospital?
LBJ Hospital/Harris Health Facility
Facebook
Instagram
LinkedIn
Twitter
Radio or TV
Word of Mouth
If you go to LBJ, how do you typically travel there?
Personal vehicle
Transit
Bicycle
Walk
Is there anything that would encourage you to take public transit to LBJ?
Frequency
Stop Location
Primary Transportation
What are your questions, comments, or suggestions regarding the new LBJ Hospital?
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Would you like to receive info in the future regarding the new LBJ Hospital?
Yes
No
Please provide the following:
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
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