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1.How would you describe your insurance status? Select all that apply.

Privately insured through an employer or family member’s employer

Insured through healthcare.gov or the state exchange

Uninsured (no health coverage)

Medicaid, Medicare or another government insurance plan

I do not know my insurance status

Other (please specify)

2.How comfortable are you using the internet to find information?

Not at all comfortable

Slightly comfortable

Somewhat comfortable

Reasonably comfortable

Very comfortable

3.How confident are you in your ability to select the right doctor, hospital or treatment for you and/or a family member?

Not at all confident

Slightly confident

Somewhat confident

Reasonably confident

Very confident

*4.When choosing a doctor, hospital or other type of healthcare provider, which of the following are most important to you when making your decision? Select up to 3.(Required.)

How much it will cost

Years of experience and education/hospital reputation

What other patients say about the doctor/hospital

How close the doctor, hospital or clinic is to me

Able to communicate electronically with provider

Allows me to make appointments by e-mail

Other (please specify)

5.When choosing a healthcare provider, do you seek out information about that provider?

Yes

No