Managed Care Participation Survey
Please share your experiences and feedback regarding your participation in managed care services. Your responses help us improve our programs.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What is your current role or relationship to managed care?
*
Participant/Member
Family Member/Caregiver
Healthcare Provider
Case Manager
Other
How long have you been involved with managed care services?
*
Please Select
Less than 6 months
6 months to 1 year
1-3 years
Over 3 years
Please rate your satisfaction with the following aspects of managed care.
*
Rows
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Access to care
1
2
3
4
5
Communication with care team
6
7
8
9
10
Quality of services
11
12
13
14
15
Timeliness of services
16
17
18
19
20
Support received
21
22
23
24
25
How easy was it to access managed care services?
*
1
2
3
4
5
Have you experienced any barriers or challenges in managed care?
*
Yes
No
If yes, please describe the barriers or challenges you have faced.
How likely are you to recommend managed care services to others?
*
Not Likely
1
2
3
4
5
6
7
8
9
Very Likely
10
1 is Not Likely, 10 is Very Likely
Please provide any additional comments or suggestions to help us improve managed care services.
Submit Survey
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