Community Health Trust Integrity Awareness Survey Form
Please complete this survey to share your perspective on integrity, transparency, and trust within the community health setting.
Respondent and Role
Respondent Type
*
Staff Member
Volunteer
Patient/Service User
Family Member/Caregiver
Community Member
Contractor/Vendor
Board/Committee Member
Other
Role or Relationship to the Community Health Trust
*
Location, Branch, or Community Area
Integrity Awareness Survey
How familiar are you with the Trust’s values and integrity expectations?
*
Not at all familiar
Slightly familiar
Moderately familiar
Very familiar
Extremely familiar
Please rate your agreement with the following statements
*
Rows
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
I know how to report a concern if I observe unethical conduct.
1
2
3
4
5
Communication from the Trust is clear and easy to understand.
6
7
8
9
10
The Trust is transparent about decisions that affect staff and service users.
11
12
13
14
15
I am confident that concerns would be handled fairly and appropriately.
16
17
18
19
20
I would feel comfortable raising a concern if needed.
21
22
23
24
25
How would you rate the Trust’s overall commitment to ethical conduct?
*
1
2
3
4
5
How likely are you to raise a concern if you witnessed a potential issue?
*
Very unlikely
1
2
3
4
5
6
7
8
9
Very likely
10
1 is Very unlikely, 10 is Very likely
Please list up to three areas where integrity awareness could be improved
Feedback and Follow-up
Suggestions or concerns
Preferred follow-up contact method
Email
Phone
No follow-up needed
Submit Survey
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