OGC Employee Healthcare Survey

With the arrival of our new medical director, Dr Tom Cheetham, the Orange Grove Healthcare Clinic is moving forward with its goal in offering top medical care to our clients.

In addition we realize that a healthy workforce is key to maintaining a healthy, happy and productive environment for our clients. We are therefore interested in possibly expanding our clinic to offer all Orange Grove Center employees the opportunity to receive their healthcare at the Orange Grove Healthcare Clinic.

If you are interested in participating in this opportunity and having the OGC Healthcare Team designated as your primary care physician, please complete the survey below. Please note that the OGC Healthcare Center is a fully dedicated private primary care practice and is not a “drop in care center” or a “Doc in the Box.”  Being a patient of the Orange Grove Healthcare Clinic would require you to fully commit to joining this practice. If you are happy with your present primary care arrangements we suggest that you continue that care. If you need a primary care provider and healthcare team and want to take advantage of having your healthcare team accessible, easy and convenient to see you may want to consider this opportunity.

In addition to expanding our healthcare clinic to our staff, we are also considering offering dental care through the expansion of our Orange Grove Dental Services. Please take a few minutes in providing your input in this potential offering by answering the questions which follow the healthcare questionnaire.

Employee Healthcare Survey

I`m interested in having the OGC Health Care Team as my primary care physician.	Yes No Undecided
My healthcare insurance coverage is provided by (name of insurance company)
In the future I would like my family members to utilize the OGC Health Care Team as their primary care physician.	Yes No Undecided
The number of my family members who might use the OGC Health Care Team as their primary care physician
I would be interested in becoming a patient at the OGC Dental Clinic	Yes No Undecided
I would be interested in having my family members enrolled in the OGC Dental Clinic	Yes No Undecided
My dental insurance company is (write N/A, if you don`t have dental insurance
I do not have dental insurance, but I would be interested in enrolling in the OGC Dental Clinic and take advantage of competitive rates	Yes No Undecided
Name of person completing this form
Please identify which department you work in
Please Enter Code Into the Textbox Below (CODE IS CASE-SENSITIVE):

Please be aware that this survey is for planning purposes only and is not a commitment on the part of OGC to provide services and not a commitment on your part to become a patient.