1. Have you ever received a hospital bill with a charge you didn’t understand or expect?
Yes
No
2. If you answered yes, did you question the charge?
Yes
No
3. If yes, were you successful in getting the charge either explained or reduced?
Yes
No
4. Do you think it’s right that 7 of the 10 most profitable hospitals in the United States in 2013 were tax-exempt non-profits?
Yes
No
5. Do you worry that your local hospital is expanding and/or adding amenities at the expense of its patients?
Yes
No
6. Do you think it should be easier for patients and/or their families to compare hospital costs?
Yes
No
Please tell us about yourself and your hospital experience:
First Name
Last Name
Email
*
Zip Code
Age
18 - 29
30 - 39
40 - 49
50 - 59
60 - 70
Over 70
FP1 Tracking: Basic Data
Origin URL
Page Title
Source URL
Query String
Date
Time
FP1 Tracking: UTM Data
UTM Source
UTM Medium
UTM Campaign
FP1 Iterable: Lists
Lists
FP1 Iterable: Workflows
Workflows
