Kiamichi Family Medical Center, Inc. (KFMC)

Community Survey

1. Are you a current user of KFMC health center services'?

               Yes________                        No________

               If “No”, have you been a KFMC patient in the past? _______    

2. If you use to be a KFMC patient, why did you stop seeking health services at the center? (brief description)

                 ________________________________________________________________________________________

                      ________________________________________________________________________________________         

3,   Are KFMC's hours of service convenient? Battiest Center (current hours are Mon.,

      Tues.,Thurs., Fri., 8 a.m. to 5 p.m. and Wed  9 a.m, to 7 p.m. Idabel Center is open on

      Tues., from 9 a.m. to 7 p.m.) Ill and Mon, Wed,, Thur., Fri., 8 a.m. until 5 p.m.

      Yes______    No_______  

       If "No", what hours of service would be best for you? _______________________  

4.   Do (KFWC) services currently offered meet your health needs?     Yes_____      No _____  

      (KFMC currently offers Medical, Pharmacy, Dental and will, in the near future, offer Behavioral)

       If "No" what services would better meet your health needs?   ______________________________

       ________________________________________________________________________________________

.     _________________________________________________________________________________________                                                                  .........

5,  Additional comments you want to share with KFMC:   ____________________________________

     _________________________________________________________________________________________

     __________________________________________________________________________________________  

     __________________________________________________________________________________________  

6.   If you would like more information regarding KFMC services, sliding fees, hours of operation, please leave your name, address and phone number below or call KFMC (580) 241-5294 Battiest Center or (580) 286-6689 Idabel Center.  

Name: _______________________________

Address:______________________________

             _______________________________

Ph.  #:   _______________________________  

'Thank you for helping us to better meet your health needs!

  P.O. Box 180, Battiest, OK, 74722 PH:  580-241-5294 FAX 580-241-5549