Have you seen a healthcare provider for your own care in the past 6 months?
If No: Which reasons apply? Select all that apply.
- Could not get an appointment
- No need for care
- Cost or coverage concerns
- Transportation or distance
- Unsure where to go
- Other
What type of provider did you most recently see?
- Primary care
- Specialist
- Mental health professional
- OB/GYN
- Urgent care or retail clinic
- Telehealth clinician
- Other
- Prefer not to say
How did you choose this provider? Select all that apply.
- Referred by another clinician
- Chose from insurance network list
- Friend or family recommendation
- Online reviews or search
- Assigned by clinic or insurer
- I already knew this provider
- Other
In the past 6 months, how many visits did you have with this provider?
Overall, how well did this provider fit your needs and preferences?
If there were mismatches, which applied? Select all that apply.
- Clinical approach not aligned
- Limited appointment times
- Communication style didn’t suit me
- Language barrier
- Cultural sensitivity lacking
- Location or travel inconvenient
- Insurance or benefits issues
- Provider gender preference not met
- Costs higher than expected
- No mismatches
- Other
How easy was it to get an appointment that met your needs?
Please rate your agreement with the following about this visit.
Do you plan to continue with this provider for similar needs?
- Yes
- No, I plan to switch
- Unsure
What, if anything, would have improved the fit between this provider and your needs?
Max 600 chars
How important are these when choosing a provider?
How would you prefer to search for well‑matched providers?
- Insurance directory with filters
- Independent review site
- Clinician referral
- Community organization recommendations
- Personalized matching app
- Other
How confident are you that you can find a well‑matched provider when needed?
Attention check: To confirm you are paying attention, please select “I agree.”
Anything else we should know about matching you to providers?
Max 600 chars
Which gender best describes you?
- Woman
- Man
- Non-binary
- Prefer not to say
What is your highest level of education?
- Less than high school
- High school or equivalent
- Some college
- Associate degree
- Bachelor’s degree
- Graduate or professional degree
- Prefer not to say
What is your current employment status?
- Full-time
- Part-time
- Self-employed
- Unemployed
- Student
- Retired
- Unable to work
- Prefer not to say
How do you primarily pay for healthcare?
- Employer-sponsored insurance
- Individual or marketplace plan
- Medicare
- Medicaid or public program
- Military/VA
- Uninsured or self-pay
- Prefer not to say
Preferred language for receiving care?
- English
- Spanish
- Chinese
- Another language
- Prefer not to say
Country or region where you usually receive care:
Max 100 chars
Welcome! This survey asks about a recent healthcare visit and what matters to you when choosing providers. Please answer based on your own care in the past 6 months if applicable.
Any final comments or examples about patient–provider fit you’d like to share?
Max 600 chars
AI Interview: 2 Follow-up Questions on patient–provider fit
Thank you for your time—your feedback will help improve patient–provider matching.