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Sliding Scale Discount Survey
*
1.
How did you hear about our sliding scale program?
(Required.)
IFHS Front Desk receptionist
Friends or family
IFHS Website
Social media platform
Other (please specify)
2.
How long have you been a participant of this program?
Less than 1 year
1 - 4 years
More than 4 years
3.
How satisfied are you with the process of applying for the sliding scale program?
Very Dissatisfied
Neutral
Very Satisfied
Clear
4.
Before participating in the Sliding Scale program, were you able to access healthcare services as needed?
Yes, regularly
Yes, but with difficulty
No, it was a significant challenge
Not applicable
5.
Since participating in the Sliding Scale program, has the ability to access healthcare services changed?
It is much easier to access healthcare services
It is somewhat easier to access healthcare services
There has been no significant change
It is somewhat more difficult to access healthcare services
It is much more difficult to access healthcare services
6.
Did the Sliding Scale program help you overcome any financial barriers that previously prevented you from seeking necessary medical care?
Yes, significantly
Yes, somewhat
No, not significantly
Not applicable
7.
Do you feel that the Sliding Scale discount you were assigned was fair and appropriate for your income level?
Yes, completely fair
Mostly fair
Neutral
Mostly unfair
Completely unfair
8.
How would you describe your overall experience with our sliding scale program?
Very Negative
1 star
Negative
2 stars
Neutral
3 stars
Positive
4 stars
Very Positive
5 stars
9.
Please provide any suggestions or comments you have for improving our Sliding Scale program.
