Rural Healthcare Access Challenges Survey
Help us understand the barriers and needs related to healthcare access in your rural community.
Your Age
*
Gender
*
Female
Male
Non-binary / Third gender
Prefer not to say
Other
Which best describes your current place of residence?
*
Village
Small town
Remote area
Other
How far is the nearest healthcare facility from your home?
*
Please Select
Less than 5 km
5-15 km
16-30 km
More than 30 km
What is your primary means of transportation to healthcare facilities?
*
Personal vehicle
Public transportation
Walking/Biking
Rely on others
Other
How often do you visit a healthcare provider?
*
At least once a month
A few times a year
Once a year or less
Only in emergencies
Please rate your satisfaction with the availability of healthcare services in your area.
*
1
2
3
4
5
Below are some common challenges in accessing healthcare in rural areas. Please indicate how much each affects you.
*
Rows
Not at all
A little
Moderately
Severely
Cost of care
1
2
3
4
Distance to facility
5
6
7
8
Lack of transportation
9
10
11
12
Limited provider availability
13
14
15
16
Limited specialist access
17
18
19
20
Clinic hours not convenient
21
22
23
24
Have you ever delayed or avoided seeking healthcare due to any of the following reasons? (Select all that apply)
Cost
Distance
Lack of transportation
Childcare or family responsibilities
Work schedule
Other
What improvements would you like to see to make healthcare more accessible in your area?
Do you have any additional comments or suggestions regarding healthcare access in your community?
Submit Survey
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