Administrator/Provider Survery

Consumer Health Information Survey
Non-active Survey

HOSPITAL DESCRIPTORS

5. What is the name and location of your hospital?

	Hospital name:
	City:
	State:
	Zip:

6. What is your hospital’s service area? Please check only one response.

Predominately suburban
Predominately urban
Predominately rural
Other (please specify)

7. What is your hospital’s size? Please check only one response.

24 or less beds
25 - 99 beds
100 - 299 beds
300 or more beds

8. Which of the following best describes your type of hospital? Please check only one response.

Government-state and local
Government-federal
Not for profit, non government church organization
Not for profit, other than church
Investor-owned
Other (please specify)

9. Is your hospital part of an academic medical center?

Yes
No
Don't know

10. Does your hospital have a library(ies) that provides the following services? Please check only one response.

Information services for health professionals only
Information services for patients and consumers only
Information services for both health professionals and patients/consumers
We do not have a hospital library at this time