Skip to content
NovumHealth Member Satisfaction Survey
*
1.
State or location
(Required.)
Arizona
California
Florida
Nevada
Utah-Southern Region
Utah-Northern Region
Texas
*
2.
Your Age
(Required.)
*
3.
Your Sex
(Required.)
Male
Female
Transgender
Decline to Answer
*
4.
Your Race/Ethnicity
(Required.)
Asain
Black/African American
Native American/Alaska Native
White/Caucasian (Not Hispanic or Latino)
Hispanic or Latino (All Races)
Pacific Islander
Other:
*
5.
Your language preference
(Required.)
Primary Language
Secondary Language
*
6.
Your Insurance Type
(Required.)
Health Plan Of Nevada/UHC Community Plan
InterMountain Health
Optum
P3
SelectHealth
SilverSummit Health Nevada
Sunshine Health Florida
Superior Health Texas
Other:
*
7.
What services have you received or are receiving? (Select all services that apply).
(Required.)
Talk Therapy
Medication Management
Long Acting Injectable (LAI)
Substance Use Treatment
Support Center
Psychiatric Evaluation
Mobile Assessment
Crisis Stabilization Center
Crisis Intervention
Care Coordination/Case Management
Peer Support Services
Group Therapy
Intensive Outpatient Program (IOP)
