In order to continuously improve the quality of Arise Health Plan’s Health Management Program, we would welcome your feedback. Please take a few minutes to complete this survey. Your responses
will be completely anonymous unless you choose to include your name.
Case Manager:  Hossam "Sam" Shalaby
Your Name (optional):

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* 1. Your Name (optional):

I am the:

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* 3. I am the:

How many times did you speak to your Case Manager?

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* 4. How many times did you speak to your Case Manager?



Please select your Satisfaction Level for questions 5 - 11.
I was able to contact my Case Manager whenever I needed assistance.

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* 5. I was able to contact my Case Manager whenever I needed assistance.

I worked with the Case Manager to determine the schedule and frequency of our contacts.

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* 6. I worked with the Case Manager to determine the schedule and frequency of our contacts.

The Case Manager helped me understand my medical condition and treatment plan.

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* 7. The Case Manager helped me understand my medical condition and treatment plan.

The educational materials received were helpful.

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* 8. The educational materials received were helpful.

The Case Manager helped me follow my treatment plan and reach my goals.

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* 9. The Case Manager helped me follow my treatment plan and reach my goals.

The Case Manager assisted me in obtaining the health care or services I needed.

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* 10. The Case Manager assisted me in obtaining the health care or services I needed.

The Case Manager helped me understand my Arise Health Plan healthcare benefits.

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* 11. The Case Manager helped me understand my Arise Health Plan healthcare benefits.

I was satisfied with the Health Management program.

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* 12. I was satisfied with the Health Management program.

Would you recommend Arise Health Plan’s Health Management program?

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* 13. Would you recommend Arise Health Plan’s Health Management program?

How could Arise Health Plan make the Health Management process more valuable to you or your family/caregiver?

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* 14. How could Arise Health Plan make the Health Management process more valuable to you or your family/caregiver?




Thank you for participating in the survey!

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