Insult to Injury: Experiences with involuntary commitment Question Title * 1. Did you receive a bill after a 5150 or involuntary committment? Yes No Question Title * 2. If ys to questions 1, mark all that apply Were you billed by the Hospital? Were you billed by the Ambulance Service? Were you billed by your insurance? Other (please specify) Question Title * 3. What county did you live in at the time of your hospitalization? Question Title * 4. Were you forced to take medication against your will? Yes No Question Title * 5. If yes to question 4, please select one below When I left the hospital I continued to take the medication When I left the hospital I stopped taking the medication Other (please specify) Question Title * 6. While in the hospital did you experience restraints?We define restraints as any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces an individual's ability to move their arms, legs, body, or head freely Yes No Question Title * 7. Were you placed in seclusion while you were in the hospital?We define seclusion as: involuntary confinement of a person alone in a room or area from which they are physically prevented from leaving. Yes No Question Title * 8. Please describe your overall hospital experience Question Title * 9. Are you willing to discuss these experiences with us? If so, please give us your first name and phone number. Done