Please fill out each question to the best of  your abilities. Type N/A in any comment boxes that don't apply to your story.
 
Please note: By filling out this survey, you are giving your consent to Christian Healthcare Ministries (CHM) to use the information you provide (including your name, your image, and/or any interview statements) now or in the future in CHM’s publications, social media, print media, electronic media, advertising, or other media or promotional activities. This consent is given in perpetuity, and does not require prior approval from you.

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* 1. What's your name and member number?

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* 2. Why did you join Christian Healthcare Ministries?

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* 3. When did the medical event start?
What made you realize you needed medical attention?
*You can describe more than one event

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* 4. Were there any complicating factors in your medical event?
If so, would you be willing to share a little of the story behind them and whether CHM was helpful to you?

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* 5. What thoughts or emotions were playing through your head during this time?

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* 6. What was your recovery like?

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* 7. How are you doing now?

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* 8. What has God taught/been teaching you through this medical difficulty?

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* 9. Did you interact with any CHM staff?

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* 10. Select any of the below information that applies to you, your membership, or your incident:

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* 11. Would you recommend CHM to other friends or family?
Why or why not?

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* 12. Have you received cards, letters, or prayers of encouragement from fellow CHM members or staff?
Were there any moments where you felt ministered to?

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* 13. Every story is unique. Is there anything else to your story that you’d like to share?

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