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How often do you visit our website?

• Every day
• Several times a week
• About once a week
• Several times a month
• About once a month
• Less than once a month
• First visit

Which of the following best describes you?

• Shands or UF employee
• Patient
• Doctor, RN, LPN, and other healthcare professionals
• Medical Student, Resident, Fellow
• General Public
• Journalist/Media
• Other:

Please rate how easy it was to find what you were looking for on our website using a scale of 1 to 5.

• 1 - Very difficult
• 2
• 3
• 4
• 5 - Very easy

What additional information or features would you like included on the Shands Jacksonville website? Please select as many as are applicable.

• Online bill pay
• Make appointments online
• Online surveys about healthcare issues
• Ask an expert
• Video of healthcare issues, interviews with expert physicians, etc
• Other:

How satisfied are you with your experience with our Shands Jacksonville website?

• Very satisfied
• Satisfied
• Neutral
• Dissatisfied
• Very Dissatisfied

If you are not satisfied, please describe the reasons below.

Would you use our website again?

• Yes
• No
• Not Sure

Please rate our website on the following features:

Optional Information

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Phone:

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Other comments/suggestions:

Please do not use this form to contact us about patient issues as we cannot guarantee a quick response. Please visit our Contact Us page for more information.

Thank you for taking the time to give us your feedback.