This survey is designed to collect reports of provider and patient experiences with the implementation of the health reform law, The Affordable Care Act (ACA). The reports will not be shared publicly, but will be used to inform and contribute to the advocacy efforts of AAHIVM. Reports of problems may also be shared with government officials by AAHIVM in an effort to address these problems at both the state and federal level. For more information or inquires, please contact AAHIVM at

* 1. What sort of experience are you reporting?

* 2. Are you a _____?

* 3. What state are you located in?

* 4. Who are you reporting on behalf of?