Arise Health Management Program Satisfaction Survey In order to continuously improve the quality of Arise Health Plan’s Health Management Program, we would welcome your feedback. Please take a few minutes to complete this survey. Your responses will be completely anonymous unless you choose to include your name. Case Manager: Hossam "Sam" Shalaby Question Title * 1. Your Name (optional): Question Title * 2. Health Management Program: Asthma Management Program Low Back Pain Management Program Hypertension Management Program Question Title * 3. I am the: Member Member's Family Non-Family Caregiver Question Title * 4. How many times did you speak to your Case Manager? One time 2 - 5 times 6 - 10 times More than 10 times One time 2 - 5 times 6 - 10 times More than 10 times Please select your Satisfaction Level for questions 5 - 11. Question Title * 5. I was able to contact my Case Manager whenever I needed assistance. Strongly Disagree Disagree Agree Strongly Agree Strongly Disagree Disagree Agree Strongly Agree Question Title * 6. I worked with the Case Manager to determine the schedule and frequency of our contacts. Strongly Disagree Disagree Agree Strongly Agree Strongly Disagree Disagree Agree Strongly Agree Question Title * 7. The Case Manager helped me understand my medical condition and treatment plan. Strongly Disagree Disagree Agree Strongly Agree Strongly Disagree Disagree Agree Strongly Agree Question Title * 8. The educational materials received were helpful. Strongly Disagree Disagree Agree Strongly Agree Strongly Disagree Disagree Agree Strongly Agree Question Title * 9. The Case Manager helped me follow my treatment plan and reach my goals. Strongly Disagree Disagree Agree Strongly Agree Strongly Disagree Disagree Agree Strongly Agree Question Title * 10. The Case Manager assisted me in obtaining the health care or services I needed. Strongly Disagree Disagree Agree Strongly Agree Strongly Disagree Disagree Agree Strongly Agree Question Title * 11. The Case Manager helped me understand my Arise Health Plan healthcare benefits. Strongly Disagree Disagree Agree Strongly Agree Strongly Disagree Disagree Agree Strongly Agree Question Title * 12. I was satisfied with the Health Management program. Strongly Disagree Disagree Agree Strongly Agree Strongly Disagree Disagree Agree Strongly Agree Question Title * 13. Would you recommend Arise Health Plan’s Health Management program? Yes No Comments: Question Title * 14. How could Arise Health Plan make the Health Management process more valuable to you or your family/caregiver? Thank you for participating in the survey! Done