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Financial Toxicity & Health Literacy Case Studies

Please complete the following survey with your success stories related to addressing financial toxicity and/or health literacy in your patient population. 

The same program may submit multiple entries. Please submit a new survey for each success story you wish to share.
1.Name(Required.)
2.Email(Required.)
3.Accredited Program Name(Required.)
4.Facility ID Number (FIN) or Company ID:(Required.)
5.My success story relates to
6.Describe the problem your program faced
7.What resources were utilized to address the problem?
8.What lessons were learned as you implemented your solution?
9.Did you utilize this effort for CoC Standard Compliance?
10.If you answered yes to Question 9, for which standard was this effort utilized?
11.Any other information you would like to share about your above experience?
12.I am authorized to give consent on behalf of my program to share this experience publicly.