Health Care Hearings Survey


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In an effort to better serve our customers, we are conducting a survey of those that have participated in first level health care service rule hearings (HCSRH). We would appreciate you taking a few moments to answer the following questions. We also ask that you provide comments where appropriate.

Bold = required fields

1. For the period January 1, 2003 to present, I have participated in the following number of HCSRH by teleconference:

1-5	6-10	11-15	15-20	20 plus

2. For the period January 1, 2003 to present, I have participated in the following number of face-to-face hearings.

0	1-5	6-10	11-15	15-20	20 plus

3. HCSRH scheduled by teleconference are more effective for my organization than face-to-face hearings.

Strongly Agree	Agree	Disagree	Strongly Disagree

4. If you answered Strongly Agree or Agree to the previous question, please state why teleconference HCSRH are more efficient to your organization (please check all that apply)

	Reduced travel time
	Quicker resolution
	Less expensive
	Less disruptive to daily schedule
	Other:

5. If you answered Disagree or Strongly Disagree to Question 3, please provide comments below:

6. HCSRH should be scheduled by teleconference.

Strongly Agree	Agree	Disagree	Strongly Agree

7. Other Comments:

FIRST NAME:		LAST NAME:
ORGANIZATION:
ADDRESS:
CITY, STATE, ZIP:
TELEPHONE NO.:
E-MAIL ADDRESS:

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