CAHPS® Clinician & Group Survey 3.0 - Adult
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  • 1. Our records show that you got care from the provider named below in the last 6 months.   Name of provider label goes here.   Is that right?
  • 2. Is this the provider you usually see if you need a check-up, want advice about a health problem, or get sick or hurt?
  • 3. How long have you been going to this provider? 
  • 4. In the last 6 months, how many times did you visit this provider to get care for yourself?
  • 5. In the last 6 months, did you contact this provider’s office to get an appointment for an illness, injury, or condition that needed care right away?
  • 6. In the last 6 months, when you contacted this provider’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed?    
  • 7. In the last 6 months, did you make any appointments for a check-up or routine care with this provider?    
  • 8. In the last 6 months, when you made an appointment for a check-up or routine care with this provider, how often did you get an appointment as soon as you needed?
  • 9. In the last 6 months, did you contact this provider’s office with a medical question during regular office hours? 
  • 10. In the last 6 months, when you contacted this provider’s office during regular office hours, how often did you get an answer to your medical question that same day?
  • 11. In the last 6 months, how often did this provider explain things in a way that was easy to understand?
  • 12. In the last 6 months, how often did this provider listen carefully to you?
  • 13. In the last 6 months, how often did this provider seem to know the important information about your medical history?
  • 14. In the last 6 months, how often did this provider show respect for what you had to say?
  • 15. In the last 6 months, how often did this provider spend enough time with you?
  • 16. In the last 6 months, did this provider order a blood test, x-ray, or other test for you?
  • 17. In the last 6 months, when this provider ordered a blood test, x-ray, or other test for you, how often did someone from this provider’s office follow up to give you those results?
  • 18. Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate this provider?
  • 19. In the last 6 months, did you take any prescription medicine?
  • 20. In the last 6 months, how often did you and someone from this provider’s office talk about all the prescription medicines you were taking?
  • 21. In the last 6 months, how often were clerks and receptionists at this provider’s office as helpful as you thought they should be?
  • 22. In the last 6 months, how often did clerks and receptionists at this provider’s office treat you with courtesy and respect?
  • 23. In general, how would you rate your overall health?
  • 24. In general, how would you rate your overall mental or emotional health?
  • 25. What is your age?
  • 26. Are you male or female?
  • 27. What is the highest grade or level of school that you have completed?
  • 28. Are you of Hispanic or Latino origin or descent?
  • 29. What is your race? Mark one or more.
  • 30.  Did someone help you complete this survey?    
  • 31. How did that person help you? Mark one or more.

Supplemental Item Sets Hide Numbering

Click on items or set of items that you want to add.

    • AC1 . In the last 6 months, how many days did you usually have to wait for an appointment when you needed care right away?
    • AC2. In the last 6 months, how many days did you usually have to wait for an appointment for a check-up or routine care?
    Patient needed care during evenings, weekends, or holidays
    • AC3. In the last 6 months, did you need care for yourself during evenings, weekends, or holidays?
    • AC4. In the last 6 months, how often were you able to get the care you needed from this provider's office during evenings, weekends, or holidays?
    Patient contacted provider's office after hours
    • AC5. In the last 6 months, did you contact this provider's office with a medical question after regular office hours?
    • AC6. In the last 6 months, when you contacted this provider's office after regular office hours, how often did you get an answer to your medical question as soon as you needed?
    Patient needed care from provider's office after regular office hours
    • AC7. In the last 6 months, did you need to visit this provider's office after regular office hours?
    • AC8. In the last 6 months, how often were you able to get the care you needed from this provider's office after regular office hours?
    Patient saw provider within 15 minutes of appointment time
    • AC9. Wait time includes time spent in the waiting room and exam room. In the last 6 months, how often did you see this provider within 15 minutes of your appointment time?
    • AC10. In the last 6 months, after you checked in for your appointment at this provider's office, how often were you kept informed about how long you would need to wait for your appointment to start?
    Patient can make appointment by email or website
    • HIT1. Can you make appointments at this provider's office by e-mail or on a website?
    • HIT2 . In the last 6 months, did you use e-mail or a website to make an appointment at this provider's office?
    • HIT3. In the last 6 months, when you used e-mail or a website to get an appointment at this provider's office, how often did you get an appointment as soon as you needed?
    Patient emailed provider’s office with a medical question
    • HIT4. In the last 6 months, did you e-mail this provider's office with a medical question?
    • HIT5 . In the last 6 months, when you e-mailed this provider's office, how often did you get an answer to your medical question as soon as you needed?
    • HIT6. In the last 6 months, when you e-mailed this provider's office, how often were all of the questions in your e-mail answered?
    Provider used a computer or handheld device during visit
    • HIT7. Providers may use computers or handheld devices during an office visit to do things like look up your information or order prescription medicines. In the last 6 months, did this provider use a computer or handheld device during any of your visits?
    • HIT8. During your visits in the last 6 months, did this provider ever use a computer or handheld device to look up test results or other information about you?
    • HIT9. During your visits in the last 6 months, did this provider ever use a computer or handheld device to show you information?
    • HIT10. During your visits in the last 6 months, did this provider ever use a computer or a handheld device to order your prescription medicines?
    • HIT11. During your visits in the last 6 months, was this provider's use of a computer or handheld device helpful to you?
    • HIT12. During your visits in the last 6 months, did this provider's use of a computer or handheld device make it harder or easier for you to talk with him or her?
    Provider's office put blood tests, x-rays, or other test results on a website for patient to see
    • HIT13. Does this provider's office put your laboratory or other test results on a website for you to see?
    • HIT14. In the last 6 months, did you look for your lab or other test results on the website?
    • HIT15. In the last 6 months, how often was it easy to find these lab or other test results on the website?
    • HIT16. In the last 6 months, how often were these lab or other test results put on the website as soon as you needed them?
    • HIT17. In the last 6 months, how often were these lab or other test results presented in a way that was easy to understand?
    Provider’s office offered patient visit notes
    • HIT18. Visit notes sum up what was talked about on a visit to a provider's office. Visit notes may be available on paper, on a website, or by e-mail. In the last 6 months, did this provider's office offer you visit notes?
    • HIT19. In the last 6 months, how did this provider's office offer you the visit notes? Mark one or more.
    Patient looked at visit notes from provider's office
    • HIT18. Visit notes sum up what was talked about on a visit to a provider's office. Visit notes may be available on paper, on a website, or by e-mail. In the last 6 months, did this provider's office offer you visit notes?
    • HIT20. In the last 6 months, did you look at any visit notes from this provider's office?
    • HIT21. In the last 6 months, how often were the visit notes easy to understand?
    • HL1. In the last 6 months, how often did this provider ask if you had any questions about your health?
    • HL2. In the last 6 months, how often did this provider use medical words you did not understand?
    • HL3. In the last 6 months, how often did this provider talk too fast when talking with you?
    • HL4. In the last 6 months, how often did this provider talk with you about the reasons for your visit?
    • HL8. In the last 6 months, how often did this provider answer all of your questions?
    • HL9. In the last 6 months, how often did this provider give you all the information you wanted about your health?
    • HL20. In the last 6 months, how often were the results of your blood test, x-ray, or other test easy to understand?
    Patient talked with provider about health questions or concerns
    • HL5. In the last 6 months, did you talk with this provider about any health questions or concerns?
    • HL6. In the last 6 months, how often did this provider show interest in your questions or concerns?
    • HL7. In the last 6 months, how often did this provider give you easy to understand information about these health questions or concerns?
    Patient saw provider for specific illness or health condition
    • HL10. In the last 6 months, did you see this provider for a specific illness or for any health condition?
    • HL11. In the last 6 months, did this provider give you instructions about what to do to take care of this illness or health condition?
    • HL12. In the last 6 months, how often were these instructions easy to understand?
    • HL13. In the last 6 months, how often did this provider ask you to describe how you were going to follow these instructions?
    How Well Providers Communicate About Medicines
    • HL14. In the last 6 months, did you start a prescription medicine?
    • HL15. In the last 6 months, how often did this provider give you easy to understand instructions about how to take your medicines?
    • HL16. In the last 6 months, how often did this provider explain the possible side effects of your medicines in a way that was easy to understand?
    • HL17. In the last 6 months, how often did this provider suggest ways to help you remember to take your medicines?
    Provider explained what a blood test, x-ray, or other test was for
    • HL18. In the last 6 months, before you had a blood test, x-ray, or other test, how often did this provider explain what it was for?  
    • HL19. In the last 6 months, how often was the explanation of what the test was for easy to understand?
    • HP1. In the last 6 months, did you and this provider talk about specific things you could do to prevent illness?
    • HP4. In the last 6 months, did you and this provider talk about healthy eating habits?
    • HP5. In the last 6 months, did you and this provider talk about the exercise or physical activity you get?
    • HP6. In the last 6 months, did you and this provider talk about things in your life that worry you or cause you stress?
    • HP7. In the last 6 months, did this provider ever ask you whether there was a period of time when you felt sad, empty, or depressed?
    Needed help from provider to make changes to prevent illness
    • HP2. In the last 6 months, did you need help from this provider to make changes to prevent illness?
    • HP3. In the last 6 months, did this provider give you the help you needed to make changes to prevent illness?
    • IC1. Please tell us how this provider and the office staff could have improved the care and services you received in the last 6 months.
    • IN7. What language would you like to talk to your provider in?
    Patient had interpreter at provider's office when needed
    • IN1. An interpreter is someone who helps you talk with others who do not speak your language. In the last 6 months, did you need an interpreter at this provider's office?
    • IN2. In the last 6 months, during visits to this provider's office, how often did you get an interpreter when you needed one?
    • IN3. In the last 6 months, how often did this interpreter treat you with courtesy and respect?
    • IN4. Using any number from 0 to 10, where 0 is the worst interpreter possible and 10 is the best interpreter possible, what number would you use to rate this interpreter?
    Patient used friend or family member as interpreter
    • IN1. An interpreter is someone who helps you talk with others who do not speak your language. In the last 6 months, did you need an interpreter at this provider's office?
    • IN5. In the last 6 months, how often did you use a friend or family member as an interpreter when you talked with this provider?
    • IN6. In the last 6 months, did you use a child younger than 18 to help you talk with this provider?
    • PN1. What are the most important things that you look for in a healthcare provider and their staff?
    • PN2. When you think about the things that are most important to you, how do this provider and their staff measure up?
    • PN3. What has gone well in your experiences with this provider and their staff in the last 6 months? Please explain what happened, how it happened, and how it felt to you.  
    • PN4. Was there anything you wish had gone differently in your experiences with this provider and their staff in the last 6 months? If so, please explain what happened, how it happened, and how it felt to you.
    • PN5. Please describe your interactions with this provider and how you get along.
    • PCMH1. Did this provider's office give you information about what to do if you needed care during evenings, weekends, or holidays?
    • PCMH4. Please answer these questions about the provider named in Question 1 of this survey.   In the last 6 months, did someone from this provider's office talk with you about specific goals for your health?
    • PCMH5. In the last 6 months, did someone from this provider's office ask you if there are things that make it hard for you to take care of your health?
    • PCMH6. In the last 6 months, did you and someone from this provider's office talk about things in your life that worry you or cause you stress?
    Patient saw a specialist for a particular health problem
    • PCMH2. Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and other doctors who specialize in one area of health care. In the last 6 months, did you see a specialist for a particular health problem?
    • PCMH3. In the last 6 months, how often did the provider named in Question 1 seem informed and up-to-date about the care you got from specialists?
    • IM1. In the last 6 months, when you visited this provider's office, how often were you examined on the examination table?
    • IM2. In the last 6 months, when you visited this provider's office, how often did someone weigh you?
    Use restroom at provider's office
    • IM3. In the last 6 months, when you visited this provider's office, did you try to use the restroom?
    • IM4. In the last 6 months, how often was it easy to move around this restroom at this provider's office?
    Pain limiting things patient needed to do
    • IM5. In the last 6 months, how often did pain limit your ability to do the things you needed to do?
    • IM6. In the last 6 months, did this provider ask about the impact of pain on your life?
    Fatigue limiting things patient needed to do
    • IM7. In the last 6 months, how often did fatigue limit your ability to do the things you needed to do?
    • IM8. In the last 6 months, did this provider ask about the impact of fatigue on your life?
    Ability to walk a quarter mile
    • IM9. A quarter mile is about 5 city blocks or 0.4 kilometers. In the last 6 months, were you able to walk that far?
    • IM10. In the last 6 months, did you have difficulty or need assistance walking that far?
    • PR1. Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and other doctors who specialize in one area of health care. Is this provider a specialist?
    Provider talked to patient about starting or stopping a prescription medicine
    • SD1. In the last 6 months, did you and this provider talk about starting or stopping a prescription medicine?
    • SD2. Did you and this provider talk about the reasons you might want to take the medicine?
    • SD3. Did you and this provider talk about the reasons you might not want to take the medicine?
    • SD4. When you talked about starting or stopping a prescription medicine, did this provider ask what you thought was best for you?
    Provider talked to patient about having surgery or procedure
    • SD5. In the last 6 months, did you and this provider talk about having surgery or any type of procedure?
    • SD6. Did you and this provider talk about the reasons you might want to have the surgery or procedure?
    • SD7. Did you and this provider talk about the reasons you might not want to have the surgery or procedure?
    • SD8. When you and this provider talked about having surgery or a procedure, did this provider ask what you thought was best for you?
    • SC1. Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and other doctors who specialize in one area of health care. In the last 6 months, did you make any appointments to see a specialist?
    • SC2. In the last 6 months, how often was it easy to get appointments with specialists?
    • SC3. How many specialists have you seen in the last 6 months?
    • SC4. In the last 6 months, how often did the specialists you saw seem to know the important information about your medical history?
    • SC5. We want to know your rating of the specialist you saw most often in the last 6 months. Using any number from 0 to 10, where 0 is the worst specialist possible and 10 is the best specialist possible, what number would you use to rate that specialist?