Salem School Survey
Please answer the following questions. Thank you for your participation in this survey.
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Does your child have a pediatrician ?
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Do you have a primary care provider ?
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Do you find it difficult to get in to your doctor?
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Do you find it difficult to get in to see your child’s doctor ?
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Is transportation an issue for seeing your doctor or your child’s doctor ?
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Do you think there is limited accessibility to doctors in your area?
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Would you be interested in a school-based clinic to evaluate and treat your family?
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Would you be interested in a school-based clinic that has a licensed provider staffed to evaluate and treat your child for common ailments and injuries?
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Do you have health insurance ?
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Does your child have health insurance?
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Is there a health clinic currently in your school?
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Is your child up to date on medical visits ?
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Do you work during normal school hours?
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Do you think a school based clinic will be beneficial to your school district/community?
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Is your child/children up to date on their routine wellness visits?
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Is your child/children up to date on their childhood vaccinations?
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In the past 12 months how many times has your child need professional medical care?
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What grade is your child in?
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I would like the schools to have the following health services available for my child: (Check all that apply)
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