1. Please take a moment to give us your feedback

Please answer the following questions about the Mapping the Maze booklet. We need your feedback to make our materials as helpful as possible.

* 1. Who reads the information in Mapping the Maze? (Check all that apply)

* 2. Will you save Mapping the Maze to read again?

* 3. Does the information in Mapping the Maze address your transplant financial concerns?

* 4. After reading Mapping the Maze, do you have a better understanding of:

  Very much Somewhat Not at all Did not read
Organizing your health care records
Organizing your financial records
How to assess your health insurance
How to assess your financial position
How to develop a financial plan
What to do if denied coverage
How to get legal help if you need it
How to access other patient resources
Health care terms (Glossary)

* 5. I found the financial worksheet in Mapping the Maze helpful in my current situation.

* 6. After reading Mapping the Maze, did you do any of the following? (Check all that apply)

* 7. Overall, how would you rate Mapping the Maze?

* 8. Would you recommend Mapping the Maze to others in your situation?

* 9. Would you recommend the Office of Patient Advocacy to others in your situation?

For the following questions, please tell us about yourself. The information provided helps us understand your needs. All answers are confidential.

* 10. Patient is:

* 11. Patient’s age:

* 12. Patient’s ethnicity:

* 13. Patient’s race (Check all that apply):

* 14. Patient’s highest level of education:

* 15. Additional comments or suggestions: