Digital Inclusion in Care Delivery Survey
Help us understand how digital tools are shaping care delivery by sharing your experiences and challenges.
Your Full Name
First Name
Last Name
Your Role in Care Delivery
*
Please Select
Patient
Caregiver
Healthcare Professional
Administrator
Other
Do you have access to the following digital devices for care-related purposes? (Select all that apply)
*
Smartphone
Tablet
Computer/Laptop
None
Other
How would you rate your comfort level with using digital tools for care delivery (such as telemedicine, patient portals, or health apps)?
*
Not comfortable
1
2
3
4
Very comfortable
5
1 is Not comfortable, 5 is Very comfortable
What barriers, if any, have you experienced in using digital technology for care delivery? (Select all that apply)
*
Limited internet access
Lack of digital skills
Cost of devices
Privacy or security concerns
No barriers
Other
Please describe any positive experiences or suggestions for improving digital inclusion in care delivery.
May we contact you for follow-up questions? If yes, please provide your email address.
example@example.com
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