POZ Focus-Money Management

Please tell us what you thought of this POZ Focus

We’d like to know whether this POZ Focus was helpful. Please fill out the following survey. We appreciate your feedback.
 
1. Please rate the overall quality of this POZ Focus:
Excellent
Good
Fair
Poor
 
2. How do you pay for your health care/clinic visits? (Check all that apply.)
Private insurance
Medicare
Medicaid
Veterans Administration (VA)
Cash
Other:  
 
3. How do you pay for your HIV medications? (Check all that apply.)
Private insurance
Medicare
Medicaid
AIDS Drug Assistance Program (ADAP)
Veterans Administration (VA)
Pharma patient assistance program (PAP)
Cash
Other:  
 
4. Have you ever stopped or skipped your HIV medication doses due to your financial situation?
Yes
No
 
5. Are you currently using any of the following pharmaceutical company co-payment programs? (Check all that apply.)
Abbott
Bristol-Myers Squibb
Gilead
GlasxoSmithKline
Merck
Tibotec
 
6. After reading this POZ Focus, has your knowledge of financial options for people living with HIV...
Incresased greatly
Increased slightly
Stayed the same
 
7. What year were you born?
 
8. What is your gender?
Male
Female
Transgender
Other
 
9. What is your sexual orientation?
Straight
Gay/Lesbian
Bisexual
Other: 
 
10. What is your yearly personal income?
Less than $15,000
$15,000 - $34,999
$35,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 or more
 
11. What is your ethnicity? (Check all that apply.)
American Indian or Alaska Native
Arab or Middle Eastern
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Other: 
 
12. What is your ZIP code?