Optional Survey Questions (Multiple Choice) - GPSC

10 In the last 12 months, how often did your regular doctor listen carefully to you? 11 In the last 12 months, did you and your regular doctor talk about healthy eating habits? 12 In the last 12 months, did you and your regular doctor talk about the exercise or physical activity you get? 13 In the last 12 months, did you and your regular doctor talk about things in your life that worry you or cause you stress? 14 In the last 12 months, did your regular doctor tell you there was more than one choice for your treatment or health care? 15 In the last 12 months, did your regular doctor talk with you about the pros and cons of each choice for your treatment or health care? 16 In the last 12 months, when there was more than one choice for your treatment or health care, did your regular doctor ask which choice you thought was best for you? 17 My health care providers take my cultural values, norms and traditions into account when we plan my care. Never Never Never Never Never Never Never Never Almost never Almost never Almost never Almost never Almost never Almost never Almost never Almost never Sometimes Usually Almost always Always Sometimes Usually Almost always Always Sometimes Usually Almost always Always Sometimes Usually Almost always Always Sometimes Usually Almost always Always Sometimes Usually Almost always Always Sometimes Usually Almost always Always Sometimes Usually Almost always Always 2 of 2